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Your patella or kneecap plays an important role in protecting your knee joint, and it also serves as the bony connection between the muscles of the thigh (or femur) and the shin bone (or tibia). The patella rests in a depression on your bone called the trochlear groove. This groove helps ensure the kneecap stays centered and tracks properly as you move your knee joint. A layer of rubbery, slick cartilage on the end of the femur, the backside of the patella, and the interior of the trochlear groove promote smooth movement of your knee when it’s bent and flexed.

Sometimes, the cartilage in these areas can become worn, increasing friction and inflammation in the joint and making physical activity very painful. Without intervention, cartilage wear will continue to worsen, and that used to mean you’d be on the fast track to a knee replacement surgery. Today, though, cartilage wear can be treated far less aggressively, using surgical techniques called patellofemoral cartilage restoration to restore damaged cartilage so the joint moves and functions normally and without pain. By restoring the cartilage, through kneecap cartilage surgery, patients can delay more aggressive surgical treatment like partial or complete knee replacement.

How is patellofemoral cartilage restoration performed?

There are several techniques that can be used to restore the patellofemoral cartilage, depending on the extent of damage, your lifestyle, and other factors. Prior to treatment, Dr. Van Thiel will perform a comprehensive evaluation of your knee’s structure and function, including diagnostic imaging of the knee joint using X-rays and, often, MRI technology to assess the soft tissues of the joint as well as the bones that comprise it. Treatment options include:

  • Microfracture: In this technique, tiny holes are created in the bone, stimulating the body’s natural healing processes to spur the growth of new, healthy cartilage over time.
  • Autologous chondrocyte implantation (MACI): MACI is a two-step process: First, a small sample of healthy cartilage is removed from your knee and sent to a lab, where the cartilage cells are grown for several weeks. Then, this new cartilage "patch" is implanted into your knee during a second procedure. Over time, the graft will fuse with the surrounding cartilage to repair and restore the damaged area.
  • Osteochondral transplantation (OAT): OAT takes a tiny graft of healthy cartilage from a size-matched donor, then transplants it to the damaged area. In some cases, an allograft (donor tissue) may be used instead of an autograft. One or several grafts may be transplanted during a single procedure.
  • Stem cell therapy: Stem cells are special cells found in the blood (and other tissues and fluids) that can be "coaxed" into transforming into other types of cells. In stem cell therapy, stem cells are extracted from your own blood, then injected into the site of injury to help spur the development of new, healthy cartilage cells. Stem cells also may be applied directly to the injured area during a minimally-invasive surgical procedure.

Some surgeries can be completed using a minimally-invasive approach called knee arthroscopy, while others require a small incision. In arthroscopy, a thin instrument called an arthroscope is inserted into the joint through a small incision. The scope uses a tiny camera to transmit images back to a monitor, enabling Dr. Van Thiel to see inside the joint and perform the surgery without the need for a larger incision. Knee arthroscopy is associated with a faster recovery time compared to more traditional “open” techniques that use larger incisions.

Am I a good candidate for patellofemoral cartilage restoration?

Patellar cartilage restoration can be an ideal solution for active men and women who are in good general health and whose knee pain is limited to specific areas of the knee – specifically, the patella and femur. Following your evaluation, Dr. Van Thiel will be able to determine if patellar cartilage restoration is the right approach for you or if another technique might be more effective and more appropriate.

Find out more about cutting-edge knee pain treatments

Dr. Geoffrey Van Thiel is a top-rated sports physician and orthopedic surgeon in the greater Chicago area, with significant experience in patellofemoral and other kneecap cartilage restoration procedures in active patients. There are many causes of knee pain, and having an evaluation is the first step in relieving pain, restoring normal function and preventing further joint damage. To learn what’s causing your knee pain ad to find out about state-of-the-art treatment options aimed at helping you maintain and enjoy your active lifestyle, call our Rockford office at   or our Elgin location at  . Schedule an appointment with Dr. Van Thiel today.

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