Cartilage Restoration Surgery in Surat

Why cartilage will not heal

Articular cartilage is the smooth white surface capping the ends of bones. It is remarkable material — slicker than ice against itself, and able to survive decades of load. It also has no blood supply, receiving nutrition by diffusion from joint fluid.

That is why it does not heal. A cut in skin bleeds, clots and repairs. A defect in cartilage does none of those things; it simply stays there. Left alone, the exposed edges degrade, the defect enlarges, and load transfers onto bone.

The purpose of cartilage restoration is to interrupt that sequence in a young joint, before a single defect becomes generalised arthritis.

Focal damage is not arthritis

This distinction decides everything.

• A focal defect is a discrete area of damage — often from a twisting injury, a dislocated kneecap or a fragment breaking off — with healthy cartilage all around it. The rest of the joint is intact.
• Arthritis is diffuse loss of cartilage across the joint surface, usually with bone changes and narrowing on X-ray.

Restoration techniques work in the first situation and fail in the second. Attempting to resurface a widely arthritic joint patch by patch does not work, and offering it in that setting sets the patient up for disappointment.

Who it suits

• Younger patients, typically under about forty-five
• A single, well-defined cartilage defect
• Healthy cartilage on the opposing surface
• A stable knee — any ligament deficiency must be corrected as well
• Good limb alignment, or alignment corrected at the same time
• Reasonable body weight
• Willingness to follow a long, protected rehabilitation

Alignment matters more than patients expect. Repairing a defect in a knee that is bow-legged simply directs load straight back onto the repair. Where alignment is significantly off, correcting it is part of the treatment rather than an optional extra.

Approaches

• Marrow stimulation. Small perforations made in the bone beneath the defect allow marrow cells to enter and form repair tissue. Simple and suited to smaller defects, though the tissue formed is fibrocartilage rather than true articular cartilage and is less durable.
• Osteochondral transfer. Plugs of bone and cartilage taken from a low-load area of the same knee and transferred into the defect. This delivers real articular cartilage but is limited by how much donor tissue is available.
• Cell-based techniques. Cartilage cells harvested, grown, then reimplanted in a second procedure. Suited to larger defects, and more involved and costly.

Which is appropriate depends on the size and depth of the defect, its location, and the patient’s age and demands.

Frequently asked questions