Rebuilding and Regenerating Damaged Knees: The Future Has Arrived!

October 27, 2014 3:26 PM

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Rebuilding and Regenerating Damaged Knees: The Future Has Arrived!

The knee is one of the largest joints in the human body. When healthy, it performs remarkably. The main part of the knee is basically a hinge joint involving the femur (thigh bone) and the tibia (shin bone). There is another articulation in the knee which involves the kneecap and is called the patellofemoral joint. Each joint surface has a cushion of articular cartilage. When normal, the surfaces glide smoothly on each other with a coefficient of friction better than ice gliding on ice. When damaged however, the cushion can have focal "potholes," areas of damage called chondral defects, or it can have areas of wear and thinning of the cushion, which is arthritis. Damaged cushions not only cause inflammation in the joint, but can grind on each other and because of a lack of shock absorption result in significant pressure and pain in the adjacent bones. Years ago, when I was in my training to become an orthopedic surgeon, I did research trying to regenerate and repair damaged joint cushions. Back then, the dictum was that once damaged, joint surfaces can never heal, and over time will continue to deteriorate leading to further damage and ultimately arthritis. Even today we know that joint cushions have very limited healing capacity, as they have no blood supply and no nerve endings (both needed for areas of the body to initiate, and complete, healing when injured or damaged). So basically, once a joint cushion was damaged, you were doomed.

In recent years, technology has exploded allowing for regeneration of damaged joint cushions. I cover this in great detail in my book FrameWork for the Knee. Thanks to orthopedic basic science researchers and some visionary clinicians, we have really come a long way in understanding the biology of j...

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