Knee injuries can be life-changing as they can restrict your movements to a large extent. You might have to give up a lot of activities that you enjoy doing. This is especially true for athletes. A minor injury can destroy your dream of continuing a career in sports. However, thanks to advances in technology and medicine, newer options are available which will allow you to continue your dream despite an injury or trauma to the knee. One such option is cartilage regeneration. 

One such option is cartilage regeneration. Dr. Bharani Kumar Dayanandam, senior orthopaedic surgeon and trauma consultant at Chennai Orthopaedics talks about the advantages of cartilage regeneration and the selection criteria for patients chosen for this procedure.

Dr. Bharani Kumar says, “Regeneration of knee cartilage is an experimental therapy aimed at treating smaller lesions in the knee cartilage. Choosing the right candidate is very essential for successful regeneration therapy”. Regeneration of cartilage is not the ideal treatment for arthritis or other extensive damage because it will not be successful. In such cases, Dr. Bharani Kumar recommends going for a total knee replacement or other options like knee osteotomy.

The first step for cartilage regeneration is identifying the location of the lesion/defect and quantifying its size using MRI or arthroscopy. A lesion between 2-5 cm is the ideal candidate for regeneration therapy or regrowing the cartilage. Anything smaller can be corrected using abrasion therapy or microfracture technique. There are 2 ways for regrowing cartilage: single-stage or 2-stage techniques.

In the single-stage technique, blood or bone marrow is taken from the patient. These are processed to get mesenchymal or stem cells. These are mixed with a tissue/glue-like substance to form a paste which is then injected into the site of the lesion. Since stem cells are pluripotent, they have the capability of growing into any type of cell depending on the site at which they are injected. Thus, when injected into the cartilage lesions in the knee, stem cells have the potential to grow into cartilage. The disadvantage of this method lies in the fact that the number of stem cells obtained cannot be determined.

In the 2-stage technique, the bone marrow aspirate is sent to a special lab that grows chondroblasts or cartilage cells from the pluripotent stem cells. After 6 weeks, when enough chondrocytes have grown, the cells are replanted into the lesion. Depending on the position of the lesion, the re-implantation is done via keyhole surgery or open knee surgery.

Complete regeneration of the cartilage tissue will take 6-12 months. It is important not to put any weight on the knee on which the surgery has been done for at least 6-8 weeks. After that, though the patient can start to do normal day-to-day activities, no strenuous activities should be undertaken for a minimum period of 6 months.

Dr. Bharani Kumar is extremely happy when this procedure is able to save the career of a talented athlete. When a pro-athlete approached him with a damaged anterior cruciate ligament (ACL), Dr. Bharani Kumar noticed a minor trauma in his knee cartilage as well during the MRI scan. Wanting to help save his patient’s career he suggested cartilage regeneration therapy along with ACL reconstruction surgery. After 2 years, the patient was back on track winning medals and making his country proud.

Cartilage regeneration is highly advantageous because the cartilage that grows back is completely natural. Since the implant is one’s own cells/ autograft there will be no adverse allergic reactions or graft rejection. “The recovery period might be longer but the results are definitely worth the wait”, says Dr. Bharani Kumar.

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