Cartilage regeneration builds a new knee, from the inside

USA Today—September 27, 2010

Articular cartilage is located at bone endings, providing a cushion and preventing bone from connecting with other bone.

Why cartilage doesn't heal on its own: It has limited ability to repair itself because it doesn't have a blood supply.

Why it hurts: When cartilage is damaged or worn down, bone hits bone where the sensitive nerve endings are located.

People who need knee replacements can scratch  cartilage repair surgery off their list, says Riley Williams, a surgeon at Hospital for Special Surgery in New York.

"If you have one, maybe two areas of isolated cartilage loss, then you are a candidate," says Williams. "If you have it on one side of the knee, the meniscus is gone, and clearly the environment of the knee has shifted toward the degenerative, then we can't help with this kind of surgery."

ACI is a two-step process:

Step 1: Healthy cartilage cells are taken from the knee using an arthroscopic tube. The cells are sent to a lab where they are cultured and multiply in about four to six weeks.

Step 2: This requires a larger incision. A layer of tissue is sewn over the damaged area. The new cells are injected under the patch, where they will regenerate cartilage with surrounding cartilage.

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