A new way to treat damaged knee cartilage

Cartilage, the slippery tissue on the ends of and between bones, provides cushioning and shock absorption.

Specifically, in the knee, the articular cartilage at the end of the thigh bone can become damaged from sports or other injuries, or even some illnesses, resulting in progressive pain and loss of mobility.

While a number of surgical procedures have been developed to restore or transplant cartilage, each is limited by the same thing.

Compared with other body tissues, cartilage has a poor blood supply, and therefore the limited potential to heal itself or to support donor cartilage.

In a recent study from Michigan Medicine, researchers found a next-generation approach to replacing damaged knee cartilage with healthy cartilage cultivated from a patient’s own cells.

The lead researcher is John A. Grant, Ph.D., M.D., F.R.C.S.C., Dip. Sports Med., an orthopedic surgeon at Michigan Medicine’s MedSport.

In the study, the team tested a new approach to restoring the viability of damaged knee cartilage.

The trial is evaluating NOVOCART® 3D, a combination device and procedure that develops “replacement” cartilage from a patient’s own cartilage cells (chondrocytes). Two surgeries are involved.

First, a biopsy is performed arthroscopically, removing a sample of healthy chondrocytes from the affected knee.

In a commercial lab, those cells are expanded and multiplied many times over before being seeded onto a collagen scaffold made to fit the shape and size of the damaged area.

In about three weeks, the cells have generated a new piece of cartilage on the scaffold. Then a second surgery is performed to remove the damaged knee cartilage and implant the scaffold with the new cartilage.

The team says the body’s own cartilage doesn’t heal well, and other options face the same challenge.

With this customized implant made from the patient’s own cartilage cells, they are hoping for a more durable, long-lasting solution.

The best candidates for the approach are patients with good overall joint health who suffer from isolated damage to the articular cartilage surface – like a pothole on their knee joint.

Patients with this type of damage often complain of focal pain in one part of the knee, swelling that doesn’t go away, or a sensation of the knee ‘clicking’ in and out of joint.

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