Articular Cartilage Preservation and Repair

  • There are multiple techniques and treatments options with variable indications and success rates and the appropriate options will be discussed
  • Patient age, the site and size of the damage, the integrity of the meniscus and ACL, and alignment of the leg will determine the best option
  • There are many injectable solutions which may help calm a damaged joint temporarily but these do not grow new cartilage and have variable evidence and outcomes. Examples include Steroid / Hyaluronic Acid / Platelet Rich Plasma (PRP) / Autologous Protein Solution ( APS – NStride) / Hydrogels ( Arthrosamid )
  • There are several surgical techniques and technologies which do preserve and repair articular cartilage including:
    • Radiofrequency coblation to smooth damaged cartilage
    • Marrow stimulation techniques (micro/nanofracture) allows stem cells to grow into fibrocartilage filling the defect
    • Use of Matrix or Gel scaffolds to aid Marrow stimulation
    • Augmentation is adding cells with growth potential to aid above two
  • If there is underlying bone loss then osseochondral grafts may be used
  • Post operative rehabilitation will involve protecting the repair either with limited weight bearing or range of motion requiring crutches or a brace