Cartilage Of The Knee

Anatomy

• ARTICULAR (or hyaline) CARTILAGE (blue tint) coats bone surfaces in joints like the non-stick coating on a frying pan.
• MEDIAL/LATERAL MENISCI are wedge shaped FIBROCARTIALGE shock absorbers within the knee.

Injury: The menisci and articular cartilage are usually damaged by a twisting injury but are also damaged by long term wear.

Diagnosis

Both standing XRs and MRI are needed to fully assess the knee.

Treatment

NON - Surgical - PRP OR STEM CELL INJECTION: We specialize in this treatment and have overall very good results in appropriate patients with articular cartilage damage, as well as for patients with degenerative meniscal tears. With thousands of injections performed we are one of the most experienced Orthopaedic centers in the world in its use.

SURGICAL: When non-surgical treatment fails, surgery is often quite effective.

• 1. MENISCECTOMY/MENISCAL REPAIR: When tearing is in the vascular zone I repair the meniscus, sometimes augmented with stem cells, otherwise partial excision is appropriate
• 2. MENISCAL ALLOGRAFT TRANSPLANTATION: I have published a “gold standard” paper on appropriate sizing. This procedure is appropriate when arthritis is not severe.
• 3. AUTOLOGOUS CHONDROCYTE TRANSPLANTATION: Your own cartilage is grown outside your body and then transplanted in. I am one of the most experienced surgeons in Illinois in this procedure over the last 20 years and have not had a treatment failure with it
• 4. HIGH TIBIAL OSTEOTOMY: Based on award winning research I have performed in this area I was selected to write the “Instructional Course Lecture” on this operation by the American Academy of Orthopaedic Surgeons. This minimally invasive procedure is necessary for cartilage surgery success when knees are malaligned. Restoration of the joint space may be seen as a result
• 5. OSTEOCHONDRAL ALLOGRAFT IMPLANTATION: Although I prefer to use the patient’s own tissue for reconstruction, in selected cases it is appropriate to use a fresh cadaveric living graft to restore knee function, and the results are usually excellent
• 6. MICROFRACTURE: I have performed hundred of these arthroscopic no-incision procedures. Most but not all patients have significant benefit.