cartilage surgery

 

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Overview

Cartilage damage can occur in the human knee from a variety of causes. The majority of these are traumatic and occur in young patients.

In the older patient when knee cartilage damage is diagnosed or encountered, then often the best choice is knee replacement type surgery which effectively resurfaces the knee joint with metal and plastic, thereby preventing bone on bone contact and improving patient’s pain and function.

In the younger patient cartilage reconstruction or resurfacing is the aim. Multiple new technologies exist these days to allow cartilage to regrow and reform on the surface of the knee joint.

Surgery

Microfracture is a technique where a small pick is used to puncture holes in the bone which is underlying the area of the damaged knee cartilage. This allows some bleeding to occur around the area of cartilage damage and that bleeding can result in release from the patient’s own blood of stem cells and regrowth of cartilage over the area of damage.

Microfracture these days can be combined with a blood patch using a technique that enhances cartilage regrowth. BST-CarGel utilises a crustacean scaffold to improve the results of microfracture with blood patch.

Other novel techniques have recently come on the market such as the Zimmer DeNovo cartilage regeneration system which uses juvenile cartilage cells to patch a defect in a patient’s knee.

Stem cell technology also exists from companies such as OrthoCell in Perth whereby a biopsy of the patient’s own cartilage is sent to Perth and that cartilage is then cloned and five or six weeks later is able to be put back into the patient’s knee as their own cloned cartilage cells. This technique however is costly and requires two operations and requires that the second operation involve opening up the knee to put the sheet of stem cells over the damaged cartilage.

A technique which has been around for some years is the OATS. Essentially this allows patients to have a section of cartilage removed from another part of their knee or from a fresh frozen Allograft obtained from a cadaver which is then inserted as a plug into the area of damaged cartilage in the knee. This plug has a core of bone and the overlying cartilage from the donor site as one unit and this is tapped into position to cover the defect in the patient’s own cartilage. This procedure has been around and available for many years but has been perfected in recent times and offers patients a single surgery solution to their cartilage damage.

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Canberra Knee Clinic.

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