Cartilage Defects

Articular cartilage is the smooth, white tissue covering the ends of the bones, allowing the bones to glide over each other with little friction. This cartilage can be damaged by injury or wear and tear.
Patients with joint injuries like meniscal or ligament tears can also lead to cartilage damage.

Treatment
The cartilage defects are normally treated using surgical interventions but the doctor might start off with non-surgical treatment options
Non-Surgical Treatment- FOR smaller defects in non articulating area, bracing and conservative treatment will help .
Surgical Treatment
There are different surgical procedures that are performed to restore the articular cartilage. Most of them are performed using Arthroscopy or keyhole surgery. During Arthroscopy, the surgeon makes tiny incisions around the joint and then inserts a tiny camera connected to an external viewing monitor. The surgeon makes use of the arthroscope to view the affected area. The surgeon will then insert long and thin specialized medical instruments and guide them to the injured area using the arthroscope and then perform the repair.
There are different procedures that are used for cartilage restoration. Some of the most common ones are:

• Micro fracture
  This helps create a new blood supply to stimulate the growth of new articular cartilage. This procedure is done in younger patients.
  This creates multiple holes in the joint surface using a sharp tool. These holes are made in the bone beneath the cartilage called the subchondral bone, creates a healing response making new blood supply reach the joint surface. This will then bring new cells to form the cartilage.
• Drilling
  This procedure also stimulates the production of healthy cartilage similar to micro fracture. In this procedure, multiple holes are drilled through the injured area in the subchondral bone with a surgical drill or wire. Drilling is less precise than microfracture and the drill’s heat can damage the surrounding tissues.
• Abrasion Arthroplasty
  This is similar to drilling but high speed burrs are used instead of drills or wires.
• Autologous Chondrocyte Implantation
  This is a two-step procedure where new cartilage cells are grown and implanted in the cartilage defect. In the first step, healthy cartilage is removed from a non-weight bearing site of the bone. These cartilage cells are cultured in the laboratory. Then these harvested cells are injected into the prepared cartilage defect.
• Osteochondral Autograft Transplantation
  In this procedure, healthy cartilage tissue is taken from one part of the joint and grafted into the region with the cartilage defect.
• Osteochondral Allograft Transplantation
  In this procedure, the cartilage defect would be larger for an autograft so the cartilage tissue graft is taken from a cadaver donor is used. This grafting method is called allograft.

Stem Cells and Tissue Engineering
There is research being conducted that focusses on the body to grow healthy cartilage tissue, called Tissue engineering. In this process, the growth factors that can stimulate new tissue are isolated and used to induce new cartilage formation.
Stem Cells are extracted from living human tissues like bone marrow, and then placed in a specific environment. They start to transform themselves into cells similar to the host tissue. By reinjecting the stem cells near a damaged joint surface will stimulate them to produce new healthy cells similar to the joint tissue.
Your doctor will suggest the best suitable type of procedure for you depending upon the size and location of the cartilage defect .