Cartilage Restoration Surgery
There was a time when people had to live with joint pain and physical limitations due to cartilage damage. But thanks to new medical advances, that time has passed. Housed at Johns Hopkins Bayview, experts at the Johns Hopkins Cartilage Restoration Center are dedicated to treatment alternatives for joint cartilage damage.
Today, innovative and exciting new developments are revolutionizing orthopaedic surgery, enabling surgeons to repair, regenerate or replace cartilage without resorting to the use of artificial joints.
Articular cartilage is the smooth, white tissue that covers the ends of bones where they come together to form joints. Healthy cartilage in our joints makes it easier to move. It allows the bones to glide over each other with very little friction.
Articular cartilage can be damaged by injury or normal wear and tear. Because cartilage does not heal itself well, doctors have developed surgical techniques to stimulate the growth of new cartilage. Restoring articular cartilage can relieve pain and allow better function. Most importantly, it can delay or prevent the onset of arthritis.
Surgical techniques to repair damaged cartilage are still evolving. It is hoped that as more is learned about cartilage and the healing response, surgeons will be better able to restore an injured joint.
• Cartilage Damage
• Hyaline Cartilage
The main component of the joint surface is a special tissue called hyaline cartilage.When it is damaged, the joint surface may no longer be smooth. Moving bones along a tough, damaged joint surface is difficult and causes pain. Damaged cartilage can also lead to arthritis in the joint.
The goal of cartilage restoration procedures is to stimulate new hyaline cartilage growth.
• Identifying Cartilage Damage
In many cases, patients who have joint injuries, such as meniscal or ligament tears, will also have cartilage damage. This damage may be hard to diagnose because hyaline cartilage does not contain calcium and cannot be seen on an X-ray.
If other injuries exist with cartilage damage, doctors will address all problems during surgery.
• Symptoms of cartilage damage
Symptoms of cartilage damage in a joint include:
joint pain – this may continue even when resting and worsen when you put weight on the joint
swelling – this may not develop for a few hours or days
a clicking or grinding sensation
the joint locking, catching, or giving way
It can sometimes be difficult to tell a cartilage injury apart from other common joint injuries, such as sprains, as the symptoms are similar.
• When to get medical advice
If you've injured your joint, it's a good idea to try self care measures first. Sprains and minor cartilage damage may get better on their own within a few days or weeks.
More severe cartilage damage probably won't improve on its own. If left untreated, it can eventually wear down the joint.
Visit your GP or a minor injuries unit (MIU) if:
you can't move the joint properly
you can't control the pain with ordinary painkillers
you can't put any weight on the injured limb or it gives way when you try to use it
the injured area looks crooked or has unusual lumps or bumps (other than swelling)
you have numbness, discolouration, or coldness in any part of the injured area
your symptoms haven't started to improve within a few days of self-treatment
• Treatments for cartilage damage
Self care measures are usually recommended as the first treatment for minor joint injuries.
For the first few days:
protect the affected area from further injury by using a support, such as a knee brace
rest the affected joint
elevate the affected limb and apply an ice pack to the joint regularly
take ordinary painkillers, such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs)
Get medical advice if your symptoms are severe or don't improve after a few days. You may need professional treatment, such as physiotherapy, or possibly surgery.
A number of surgical techniques can be used, including:
encouraging the growth of new cartilage by drilling small holes in the nearby bone
replacing the damaged cartilage with healthy cartilage taken from another part of the joint
replacing the entire joint with an artificial one, such as a knee replacement or hip replacement – this is usually only necessary in the most severe cases