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Cartilage Restoration & Preservation
Articular cartilage is the smooth, white tissue that covers the ends of bones where they come together to form joints. It acts as a shock absorber and a frictionless surface, allowing joints to glide smoothly. Unfortunately, cartilage has a very limited blood supply, meaning it cannot heal itself effectively when damaged by trauma, sports injuries, or wear and tear.
Historically, focal cartilage damage in younger patients eventually led to severe osteoarthritis and the need for a joint replacement. Today, Cartilage Restoration and Preservation techniques aim to regenerate this vital tissue, relieve pain, and significantly delay or prevent the need for an artificial joint [1].
Who is a Candidate for Cartilage Restoration?
Cartilage restoration is most successful in younger, active patients (typically under 50 years of age) who have an isolated, focal area of cartilage damage (a "pothole" in the cartilage) rather than widespread, bone-on-bone osteoarthritis. Dr. Nihar Modi conducts a thorough clinical examination and MRI review to determine if you are a candidate for these advanced procedures.
Advanced Cartilage Restoration Techniques
Dr. Nihar Modi employs several state-of-the-art techniques to repair and restore damaged cartilage, often performed minimally invasively via arthroscopy:
Microfracture
A well-established arthroscopic procedure where tiny holes are created in the exposed bone at the site of the cartilage defect. This stimulates the release of bone marrow stem cells, which form a "super clot" over the defect and mature into fibrocartilage, filling the gap.
OATS (Osteochondral Autograft Transfer System)
Also known as a mosaicplasty. This procedure involves taking small, cylindrical plugs of healthy bone and cartilage from a non-weight-bearing area of your own knee and transferring them to the damaged weight-bearing area, much like replacing a damaged floor tile with a healthy one.
Autologous Chondrocyte Implantation (ACI) / MACI
A two-stage procedure for larger defects. First, healthy cartilage cells are harvested from your knee and sent to a lab to multiply. Weeks later, these millions of new cells are implanted back into the damaged area, often secured by a bio-membrane, where they grow into healthy hyaline-like cartilage [2].
Non-Surgical Preservation: Orthobiologics
Cartilage preservation isn't always surgical. Dr. Nihar Modi also utilizes advanced orthobiologics, such as PRP (Platelet-Rich Plasma) therapy. This involves concentrating the healing factors from your own blood and injecting them directly into the joint to reduce inflammation, improve joint fluid quality, and support the surrounding tissues.
References:
- Mithoefer K, et al. "Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis." The American Journal of Sports Medicine. 2009.
- Brittberg M, et al. "Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation." New England Journal of Medicine. 1994.
