The Basics of Knee Cartilage Replacement

Can knee cartilage heal on its own?

What is knee cartilage replacement?

What is recovery like for knee cartilage repair patients?

Is knee cartilage repair right for me?

Knee pain is one of the most common types of pain among both men and women — especially chronic or recurring knee pain. And while there can certainly be different causes of chronic pain — a sprain or strain, for instance — when it comes to ongoing knee pain, it’s often your cartilage that’s to blame. Cartilage forms a slick, rubbery “cover” for the ends of the bones that meet in a joint. When the joint is healthy, the cartilage layer reduces friction and helps your knee bend and flex smoothly and without pain. But when the cartilage is worn or damaged, it doesn’t work as well. Your knee doesn’t glide so smoothly. Friction between the bones builds up, causing pain and inflammation. Over time, the inflammatory processes combined with additional wear and tear result in more cartilage damage — and more pain.

Not too long ago, damaged knee cartilage meant you had two treatment options to choose from: try to reduce the pain and dysfunction with pain medicines and physical therapy, or have the joint replaced entirely. Since pain relievers and therapy can only go so far in reducing symptoms, that left most patients with just one choice: knee joint replacement surgery.

Happily, that’s changed. Today there’s another option for knee pain associated with cartilage damage. It’s called knee cartilage replacement (or sometimes, knee cartilage repair).

Can knee cartilage heal on its own?

Cartilage can heal on its own — to some small degree. But unlike other tissues — your skin, for instance — cartilage doesn’t have a very good blood supply. Tissue healing depends on blood supply to bring oxygen and repair “factors” that help the tissue regenerate. Since cartilage doesn’t have that robust blood supply, healing is slow and typically incomplete. That means if your cartilage is worn or damaged by a fall or other injury, it’s going to take a long time for any type of healing to occur. And even when it does occur, chances are very good you’re going to continue to have pain and stiffness. In fact, once your cartilage is damaged and inflammation inside the joint increases, it’s also pretty certain that damage will continue and your pain will become a lot worse.

What is knee cartilage replacement?

Knee cartilage replacement is a surgical procedure that uses cartilage grafts to repair damaged cartilage and restore normal movement in your knee joint. As a top cartilage repair and replacement specialist, Dr. Van Thiel uses two primary methods for knee cartilage repair:

The first approach is called osteochondral allograft surgery. Allograft surgery uses cartilage grafts from donors. The graft is carefully matched in size, shape and thickness so it “fits” perfectly in the damaged area.
The second method is called MACI, which is short for matrix-induced autologous chondrocyte implantation. MACI uses cartilage cells harvested from a healthy area of your knee joint. Those cells are “grown” in a lab for several weeks until they form a graft of tissue that can be implanted into your knee.

Some patients benefit from another technique called microfracture. In this method, tiny holes are drilled into the surface of your knee. The holes stimulate your body’s healing processes. Over time, form new, healthy cartilage cells to replace the damaged cartilage.

Often, knee cartilage repair surgery can be performed arthroscopically, using tiny instruments and a special camera that allow Dr. Van Thiel to repair your knee without large incisions. Arthroscopic surgery is also associated with less bleeding and bruising postoperatively, along with faster healing.

Recovering from knee cartilage repair

After your knee cartilage replacement surgery, you’ll need to provide the joint with some TLC. The length of your recovery will depend on how much cartilage is replaced, your own health, and other factors. Most people use crutches for four to six weeks, returning to some level of activity by about two months after their surgery. A return to full activities can take a few months. That gives your knee cartilage time to grow and strengthen.

You’ll also have physical therapy to keep your knee flexible and help in healing. Regular, gentle knee movement is important for maintaining your joint fluid, which in turn supplies the cartilage with nutrients important for healing. The most important step during your recovery is to follow the instructions provided by Dr. Van Thiel and your therapist. They can help you increase your activity level over time so your new cartilage is protected as it grows.