The human knee is a delicate structure, and those who have played sports or done any activities that are high impact know it better than anyone. They’ve felt the pain during the activity, felt sore for weeks after, and have thought to themselves whether or not the activity was sustainable – whether it would be possible to enjoy it into their old age, or whether instead it would render them immobile for their later years. There is hope though, as a new surgical technique in the works has shown to significantly help with cartilage regeneration.
A model of a knee joint. Holly Anissa via Flickr.
The knee is one the most complex joints in the body, and is the meeting place of the femur, the tibia, and the fibula, and is composed of bone, muscle, ligament, tendon, and cartilage. It contains four ligaments (LCL, PCL, ACL, MCL), responsible for the stabilization of the knee joint, a number of tendons, and two large pieces of cartilage that are responsible for absorbing shock and bearing weight.
I wonder if he’ll be able to do that again in twenty years?
Courtesy of Teebzguy via Youtube
The prognosis isn’t the best for athletes (both amateur and professional) that participate in a number of popular sports, the highest incidence of knee injury resulting from participation in Football, Skiing, Basketball, Rugby, and Soccer. Although very common injuries include the tearing of the Anterior Cruciate Ligament (ACL) and the Medial Collaterial ligament (MCL), cartilage damage is still a very large concern for both athletes as well as the medical community taking care of such injuries. Due to the strenuous forces associated with these high impact sports, over time, the two large pieces of cartilage in the knee wear down. For some athletes, if left untreated, these pieces of cartilage can wear down completely, until all that is left is bone. When this occurs, simple movements of the knee will result in excruciating pain, as the femur, tibia, and fibula all grind together.
There is good news though! A game changing technique coming out of Johns Hopkins University has proven to lead to significantly higher cartilage regeneration than previously used techniques. Current cartilage repair is undergone by drilling tiny micro holes into surrounding bone, in an attempt to allow the stem cells inside the bones to seep out and form into new cartilage. A study, headed by Blanka Sharma, shows that this old technique led to an average of 64% of the tissue being replaced. The new technique, however, employs the use of a hydrogel along with the drilling, and has shown to lead to an average of 86% of tissue regeneration. Jennifer Elisseeff, Ph.D, along with a number of her co-workers speculated that the old technique was ineffective because it lacked structure for the stem cells to grow on. After years of laboratory testing, the first trial proved a success, MRIs showing there to be no mal-effects associated with the hydrogel implants as well as the increased tissue regeneration.
The technique is still waiting for European approval, and for the time being has been taken over by an independent American company, Biomet. Jennifer Elisseeff, Ph.D has high hopes for the technique, stating that she hopes that “it will become a routine part of care and improve healing”.
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