When Joint Replacement Isn’t Warranted, These Procedures Can Relieve Pain and Improve Function.
Hyaline cartilage is the smooth white tissue that covers the ends of bones that meet to form joints. Healthy cartilage allows the bones to glide easily over each other, enabling smooth motion.
Injury or everyday wear and tear can damage this tissue, making movement difficult and painful. Potentially, the deterioration can lead to arthritis. Lacking blood vessels, cartilage doesn’t heal well on its own.
Cartilage injuries are common, especially in the knee joint, and can lead to degenerative arthritis. The strategy for treating these damaged areas of cartilage, called lesions, depends upon patient age, activity level, duration of the problem, limb alignment, and size and location of the defect. Young, active patients are not ready for a joint replacement, and may best be treated with cartilage repair procedures.
We treat the injured joint as a whole – not just the lesion – and tailor our treatment to the needs of the patient. Our experts cover the entire range of cartilage injuries as well as most joints (knee, hip, ankle, shoulder, elbow) and treat patients of all ages.
Brett D. Owens, MD, has a lab to unravel the mysteries of cartilage and improve surgeries. He researches better ways to perform common yet challenging joint operations.
"I am proud to be here full time as your local orthopedic surgeon." - Dr. Brett Owens
In microfracture, the area of damaged cartilage is removed, and an instrument is used to make holes in the underlying bone. This exposes small subsurface blood vessels, which will grow into the area and bring with them the growth factors that will eventually produce fibrocartilage. “Adjunctive scaffolds,” frameworks to help cartilage grow, are inserted.
Although fibrocartilage is not as durable as normal hyaline cartilage, this substitute often works well, especially if a patient is young and the defect is small. This procedure can be performed arthroscopically, using small incisions and a special instrument.
This procedure involves surgery to obtain a sample of normal cartilage, which is sent to a laboratory. From the sample, cartilage cells are multiplied into millions of cells. A minimum of six weeks after the sample is harvested, these cells are implanted during a second surgery, generating new hyaline-like cartilage to repair the defect. The Brown University Health Cartilage Repair surgeons are certified by Carticel.
This procedure involves replacing the damaged cartilage and underlying bone with a size-matched graft from an organ donor with healthy cartilage. The cartilage repair experts perform a large number of these transplantations.
This procedure is performed in patients whose meniscus — the cartilage in the knee joint that acts as a shock absorber between the thighbone and the shinbone — is no longer present. A size-matched meniscus graft from an organ donor is implanted arthroscopically. The cartilage repair team performs many MATs.
