What causes cartilage damage?
Traumatic sports injuries, repetitive use injuries, and traumatic auto and fall injuries, often cause cartilage damage, and lead to chronic pain and disability. With age, the cartilage on the ends of the bones, called articular cartilage, degenerates and is subject to Osteoarthritis.
What happens when cartilage is damaged?
Damaged cartilage causes joint pain and poor function. Most knee pain is due to cartilage damage. Untreated cartilage damage can lead to Osteoarthritis (OA).
Can damaged cartilage heal on its own?
No. Articular cartilage has no ability to heal itself because it has no blood supply to provide the cells with the proteins and nutrients essential to healing.
What is the treatment for cartilage damage?
Cartilage transplants can regenerate cartilage and repair damage. However, cartilage restoration and regenerative procedures are only beneficial before the damage develops into osteoarthritis (OA).
What is cartilage restoration?
Cartilage restoration procedures are intended to enlist and encourage the body’s natural healing power.
Who is a good candidate for cartilage restoration?
People with heathy joints who have damaged cartilage are good candidates. Cartilage restoration procedures are next generation treatment to restore full function as naturally as possible, and to help you avoid OA.
What are the different cartilage restoration techniques?
- Microfracture
- Osteochondral autograft/allograft transfers (OAT)
- Autologous chondrocyte implantation (ACI)
- MACI is autologous cultured chondrocytes on porcine collagen membrane.
- BioCartilageâ Extracellular Matrix
What is microfracture?
Microfracture is a procedure that creates multiple holes in the bone beneath the cartilage. It may be done with a hand-held instrument, or drilling into the bone. The purpose is to create a healing response that stimulates the creation of new blood vessels and new cartilage cells to repair the damage.
Osteochondral autograft/allograft transfers (OAT)
OAT is a minimally invasive procedure intended to restore function, reduce pain and slow the progression of cartilage degeneration. During the OAT procedure, a piece of healthy cartilage is removed from an area that surrounds the damage (an autograft), and transplanted into the defect to repair the cartilage. When there is damage to both the bone and cartilage, donor cartilage and bone may be necessary to replace the damage (an allograft).
Autologous chondrocyte implantation (ACI)
ACI is a technique for regenerating articular cartilage. The ACI procedure involves harvesting your healthy cartilage from the joint, and sending it to a special lab where it is cultured for several weeks to create millions of cartilage-producing cells (chondrocytes).
Three to five weeks later, the lab returns the cultured cells to the Dr. Stark. Using minimally invasive arthroscopy, Dr. Stark injects the cells on to a matrix, and transplants the cultured cells into the defect. The cartilage cells grow and mature, and gradually replace the damage with healthy cartilage.
ACI can be used for any joint, but 90% of the time, it is used for the knee. It can also be used for the ankle. Rehabilitation is necessary to restore full weight bearing of the joint. This is a great option for young athletes and children who have small, single defects. Complete recovery requires 9-12 months. ACI is also used to treat large cartilage defects, and is superior to microfracture.
MACI
In MACI, your own cartilage cells are retrieved by biopsy, and grown in a special laboratory similar to ACI. But here, the cultured cells are implanted on to a collagen matrix film and sent back to your surgeon. The patient returns for minimally invasive surgery where Dr. Stark tailors the implant to the size of the defect. This patch is then implanted into the damaged area. As the cartilage fills in, the matrix is absorbed into your tissues. Functional repair tissue alleviates symptoms and restores joint function within 6 months after the procedure.
BioCartilage
A BioCartilage matrix is created with sterile, donor articular cartilage powder combined with Platelet Rich Plasma (PRP) or bone marrow concentrate. The BioCartilage matrix is injected in to a scaffold which is implanted into the damaged area. New cartilage cells grow to fill in the defect. PRP growth factors activate growth and repair of the cartilage, support stem cells to regenerate cartilage, and maximize cartilage repair. BioCartilage repair is effective for small areas of cartilage damage.
Dr. Erik Stark has office in Carlsbad.