Cartilage Repair

 

Many of our joints will suffer a tremendous amount of stress loading during the course of our lifetime. Most people who enjoy any type of sport, do manual work or those of us who have to sit at a desk all day will complain of joint pain at some point in our life. Damage to the cartilage is often the culprit, whether due to a trauma or  just general ‘wear and tear’. But cartilage, once damaged, cannot repair itself.

   

  Drawing of a knee and it's ligaments

  

There are now several new treatment options available to help overcome this problem. Synthetic joint fluid replacement is one of these techniques. This artificial fluid has almost the same chemical and physical potential as normal joint fluid. It is given by  injection into the affected joint once a week for 3 to 5 weeks and helps to reduce inflammation within the joint.  It supplies the cartilage with the necessary nutritive elements  to regenerate. This can be used for medium and large joints such as the hip (under X-ray control), knee, ankle, shoulder or elbow, and for the small joints of the hand and foot.

The pain reducing effect of these injection can last up to two years, winning valuable time before one has to go through surgical intervention.

Several other techniques have emerged for treatment of localised cartilage damage, for example a hole in the cartilage. So called autologue cartilage transplantation is one of these techniques. This involves taking some healthy cartilage, just a few millimetres in size, from the non-weight bearing part of the joint. This can be done with keyhole surgery and also allows the orthopaedic surgeon to see for himself the extent of the damage within the joint. These cartilage cells are then cultivated in a special laboratory and after 2 to 3 weeks the multiplied, healthy cartilage cells are re-implanted during open joint surgery. It takes about one week in hospital to recover from the operation during which time the knee is actively and passively mobilised. But full weight bearing is not allowed for about 6 weeks following surgery. Although the rehabilitation time is several months, the long term results are very encouraging and you will be back to work and enjoying your previous sporting life in a relatively short time!

 
Another popular procedure  in use today is the mosaic technique. The idea behind this technique is similar to the cartilage transplant. The hole(s) in otherwise healthy cartilage are filled in.  With the mosaic technique small pieces of cartilage are taken out from the non-weight bearing area of the joint and directly placed into the holes.

After a thorough orthopaedic examination, including x-rays and ultrasound (both available in the clinic), a decision would be made together with the patient, which specific treatment should be applied.