Cartilage regeneration is often considered as a solution to osteoarthritis. However, the techniques for this surgery are still evolving. Read on to know more..

Osteoarthritis is the ailment that plagues millions of people across the world. Around 15 million people suffer from failure of knee joint cartilage alone. Hip osteoarthritis and shoulder osteoarthritis are also pretty common. Yet, the articulate joint of the knee is most vulnerable to cartilage degeneration. Attempts are made towards regeneration or reconstruction of cartilage so as to reverse the effects of osteoarthritis. However, cartilage replacement and regeneration techniques are yet to be evolved completely, at least in the US.

What is Cartilage Degeneration

Cartilage comprises collagens, proteoglycans, and non-collagenous proteins. Cartilage connective tissue is mostly found in the articulate joints of the body. Proper lubrication of these joints is necessary for normal movement. Cartilage connective tissue also prevents the joints from injuries and damage by absorbing the external shocks. The most vital component of cartilage connective tissue is water. Water forms about 85% of the total structure of cartilage connective tissue. High levels of water ensure better lubrication of joints and thus facilitates normal movements of the body. However, as one grows older, the content of water begins to diminish from the cartilage connective tissue. Natural wear and tear makes it difficult to replenish the loss of fluids from the joints. The body starts to overcome this loss by producing specialized cells called fibrocartilage cells, which fill up the sockets in the joints. However, the production of fibrocartilage does not cover up the significant fluid loss. As a result, the joint swells and the person experiences immense pain even during slightest movement.

What is Cartilage Regeneration

Cartilage regeneration is the process which attempts to repair the degenerated cartilage. This procedure is currently being targeted by researchers and tissue engineers, owing to the large number of people suffering from knee osteoarthritis. Hip and shoulder cartilage regeneration techniques are still in their infancy. Currently, following techniques are in practice.

Debridement or Abrasion
In this technique the surgeon arthroscopically removes the loose cartilage, thereby causing bleeding at the bone surface. This process also encourages the production and growth of fibrocartilage. However, the resulting fibrocartilage may not be strong enough to sustain the load or shocks.

Microfracture
This is a technique in which the surgeon arthroscopically removes the affected part of the cartilage. Several perforations are made on the bone surface to stimulate the blood flow as well as to encourage the growth of fibrocartilage.

Mosaicplasty or Osteochondral Autograft Transplantation Surgery
This is a cartilage regeneration technique in which a plug of bone covering a cartilage is surgically removed from the healthy region of the body. This plug is then transplanted on the damaged cartilage. As the plug is retrieved from the same person this technique yields fair results.

Periosteal Flap
In this technique the surgeon removes a part of the periosteum which is basically a connective tissue that covers all bones and then transplants it to the affected area of cartilage. Mostly periosteum from shin is used for this purpose.

Autologous Chondrocyte Implantation
In this technique small part of cartilage from the healthy joint (mostly knee) is extracted and sent to the laboratory for tissue culture. The laboratory grown cultures are implanted inside the affected cartilage joint.

Osteochondral Allografts
In this technique plug of bone covering a cartilage is used from a donor to repair the damaged cartilage. However, since the plug is obtained from a foreign body, some rejection issues may arise.

Cartilage regeneration techniques are advancing at a fast pace. So far, these techniques have produced mixed results, which restricts their implementation on a greater scale. However, with some improvements in future, these techniques can be implemented to relieve millions of people from osteoarthritis.