Coaxing Knee Cartilage to Regrow

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Coaxing Knee Cartilage to Regrow

Technique Offers Long-Lasting Pain Relief, Delays Knee Replacement

Surgery, Study Shows

By Miranda Hitti

WebMD Medical News

Reviewed By Ann Edmundson, MD

on Thursday, March 09, 2006

March 9, 2006 -- A new study shows that regrowing knee cartilage

might help people delay knee-replacement surgery.

Cartilage covers the knee's bones. With wear and tear, cartilage

gradually softens, then cracks, and finally develops large holes.

Without cartilage to serve as a shock absorber, knee bones rub

against each other, causing pain and more damage.

The technique used in this study spurs knee cartilage to grow back,

which could cut pain and improve knee function, write Stone,

MD, and colleagues.

Stone's study appears in The Journal of Arthroscopic and Related

Surgery.

New Approach

Stone's study included 125 patients who were about 46 years old, on

average. Cartilage on the weight-bearing part of their knees had worn

away in large patches.

The surgery was done using arthroscopy, which is less invasive than

knee replacement. In arthroscopy, doctors make a small incision in

the knee and insert a pencil-sized instrument called an arthroscope.

For each patient, the researchers took cartilage from another part of

the knee and crushed the cartilage into a paste. After roughing up

the cartilage surface, the paste was spackled over the damaged area.

The goal was for cartilage-producing cells in the paste to take root

and make more cartilage.

The patients were followed for up to 12 years. More than eight out of

10 were considered a " success, " write Stone and colleagues. In those

patients, knee pain fell and knee function improved.

The biggest average improvements were in pain and in going up or down

stairs. The results didn't vary by sex, age, or previous surgery, the

study shows.

New Cartilage

Later on, the researchers checked 66 of the patients' knees. They

found signs of regrown cartilage in 42 cases. In 18 cases, regrown

cartilage looked the same as normal cartilage, Stone's team reports.

The regrown cartilage was " very durable for two to 12 years in most

patients, " the researchers write. Stone's team notes that further

studies should be done.

Meanwhile, they call the technique " cost-effective " and note

" excellent, long-lasting pain relief; restored function; and the

possibility of tissue regeneration " for such patients.

" While we cannot make normal cartilage, repair tissue may be

sufficient for patients to 'buy time,' await newer cartilage

regeneration procedures, and ultimately delay joint [replacement], "

write the researchers. "

SOURCES: Stone, K. The Journal of Arthroscopic and Related Surgery,

March 2006; vol 22: pp 291-299. News release, The Stone Research

Foundation.

http://www.webmd.com/content/article/119/113477