Cartilage restoration procedures now viable for the over 40s, says two studies
Two new studies at the Hospital for Special Surgery (HSS) and presented at the annual meeting of the American Academy of Orthopaedic Surgeons, has found that cartilage restoration surgery, using various types of “plugs” to fill the hole or damaged area, is a viable treatment for people over 40.
Dr Riley J Williams III, a lead author and director of the Institute for Cartilage Repair at HSS, says that while various cartilage restoration procedures have demonstrated success rates ranging from 50% – 90%, the majority of reported results were in patients aged 30 or younger.
“Our studies are the first to look at outcomes of three specific procedures used to repair damaged cartilage in patients over 40,” he says.
For the HSS studies patients had degenerative changes in their cartilage and isolated areas of pain and swelling, characteristic of arthritis. Most of the patients did not meet the criteria for total knee replacement. Cartilage restoration is not intended for patients with advanced bone-on-bone arthritis.
The first study included 35 patients whose damaged cartilage was under their kneecap. The second study included 61 patients whose cartilage damage was at the end of their femur bone in the knee joint. The mean age in both studies was 51.5, and participants had no knee injury other than the cartilage lesion. All had a minimum follow-up of two years after surgery.
Dr Williams performed cartilage restoration surgery using various types of “plugs” to fill in the hole, or damaged area. More than half of the patients received a synthetic plug. The other patients received either a donor cartilage plug or a small plug of cartilage transferred from another healthy area of their knee that did support their weight.
At the average follow-up of 3.5 years, the vast majority of patients reported higher activity levels and decreased pain, as well as a high degree of satisfaction with the procedure, according to Dr Williams. There were no statistically significant differences in outcomes among the different treatments.
“For the first time, this middle-aged group of athletic individuals may have some good options to repair cartilage lesions,” says Dr Williams. “In addition to improving their quality of life, this may help them delay the need for a knee replacement down the road. ”
Image credit: Muffet68
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