Will Cartilage Grow Back
Research on joint cartilage has been extensive. For decades, researchers have been able to successfully regrow cartilage in the laboratory. However, it has been far more challenging transferring these techniques to actual living joints.
One procedure, called microfracture surgery, involves drilling small holes in the bone directly underlying joint cartilage. This creates a super clot of blood and stem cells in the area, with the goal of triggering cartilage regrowth.
Results have been mixed, and any positive results seem short-lived. In the best cases, theres some cartilage regrowth, but there is often accompanying bone regrowth that complicates matters. Furthermore, the cartilage is often fibrous cartilage instead of the hyaline cartilage that normally grows on joint surfaces.
Another procedure utilizes the same microfracture surgery followed by a procedure to glue” a hydrogel-like scaffolding to the joint surface. The results appear to be better than microfracture surgery alone. With just the microfracture surgery, the initial pain reduction patients experience lasts only about three months. Those who have received the gel scaffolding reported less pain even at six months.
But heres the good news: New research confirms we do have the ability to restore cartilage in our joints!
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It may be inevitable for your body to age over time but that doesnt mean you cant live your life to the fullest. Thanks to modern technology, there are medical treatments today that can help you alleviate the symptoms of joint damage and delay the aging process of your joints.
Dr. Usman Ahmad can guide you with the best non-surgical approach for your condition. Advanced Sport & Spine provides pain management treatments in Charlotte for patients with sports, occupational, and accident injuries. Schedule an appointment today and discover how you can get your life back by walking and moving once again.
Humans May Possess Ability To Regrow Cartilage
HealthDay Reporter
WEDNESDAY, Oct. 9, 2019 — Humans may lack the salamander skill of regrowing a limb, but a new study suggests they do have some capacity to restore cartilage in their joints.
The findings run counter to a widely held belief: Because the cartilage cushioning your joints lacks its own blood supply, your body can’t repair damage from an injury or the wear-and-tear of aging.
And that, in part, is why so many people eventually develop osteoarthritis, where broken-down cartilage causes pain and stiffness in the joints.
But that lack of blood supply does not mean there’s no regenerative capacity in the cartilage, according to Dr. Virginia Byers Kraus, the senior researcher on the new study.
In fact, her team found evidence that human cartilage can, to some degree, renew itself, using a molecular process similar to the one that allows a salamander to grow a new limb.
The researchers are calling it the “inner salamander capacity.”
“For the first time, we have evidence that the joint has the capacity to repair itself,” said Kraus, a professor at Duke University School of Medicine, in Durham, N.C.
Specifically, she explained, that capability exists in a “gradient.” It’s greatest in the ankle, less apparent in the knee, and lowest in the hip.
Dr. Scott Rodeo, an orthopedic surgeon not involved in the study, said the findings raise some interesting questions.
As it happens, microRNAs also help salamanders regrow lost limbs.
Science Advances
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Physical Steps To Restore Joint Cartilage
First and foremost, its important to limit high-impact damage to joint cartilage.
Activities like jogging, jumping from high objects, and impact sports may be fine for younger people, since joint cartilage, ligaments, tendons, and other structures are more flexible and forgiving. But as we get older, the pounding places undue stress and damage on joint cartilage. Thats why you would be hard-pressed these days to find an older professional football player who doesnt have severe joint problems and/or a joint replacement.
Additionally, obesity places constant and unnecessary stress on the joints, which is increased even more when walking or doing upright activities. Losing even a few pounds of excess weight can make a profound difference in both joint pain and long-term joint health.
Likewise, its important to move every joint in the body through its complete range of motion every day. Since cartilage doesnt have a blood supply like other living tissues, it must receive its nutrients and remove any waste material by way of the synovial fluid within the joint capsule. Range-of-motion exercises help ensure this synovial exchange of fluid occurs regularly over the entire joint surface.
Regular exercise is essential for joint health too. Exercises that dont unduly compress joint cartilage can help preserve joint mobility and stability, and overall circulation. Exercise also helps decrease stress hormones and inflammation throughout the body.
Institute For Cartilage Repair
The HSS Institute for Cartilage Repair focuses on the treatment of symptomatic cartilage lesions. Articular cartilage, the cartilage that lines joints such as the knee, hip, ankle and shoulder, does not have the capability to repair itself. As such, injuries to cartilage surfaces often result in pain, poor joint function, and arthritis. The Institute for Cartilage Repair was developed by a skilled group of clinicians in response to growing clinical need for more durable cartilage and meniscal repair procedures. Its multidisciplinary team of surgeons, radiologists, clinicians, physical therapists, and researchers have focused on the problems of detecting and treating cartilage injury for many years and offer the latest in surgical treatment, diagnostic imaging, and clinical outcomes research. The Institute offers patients a comprehensive resource in specialty cartilage repair.
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What Is The Function Of Cartilage
Cartilage is the cushion at the end of our bones that prevents our bones from rubbing against each other and causing pain. It is soft enough to change its shape and absorb compressions in our joints whenever we stand, move our wrists, or sit.
Cartilage is made of four substances: collagen, proteoglycans, water, and chondrocytes. Water makes up 70% of the cartilage, and when we stand, it acts like a sponge to handle the compression. The cartilage covers the end of the bone, changes its shape, and squeezes water to coat your knee joints. Once you sit, the cartilage decompresses and reabsorbs the water released to your joints.
When we were younger the tips of our bones used to be cartilage that developed into bones as we grew older. However, as an adult, you can still find cartilage in several parts of your body aside from your joints. The types of cartilage in our body are:
- Hyaline cartilage or articular cartilage is a springy but tough type of cartilage that covers your ribs, supports your windpipe, and protects your joints.
- Elastic cartilage is a type of cartilage with a springy form and can be found in our ears and nose.
- Fibrous cartilage is the weight-bearing type of cartilage that is found in your spine and hips.
Groundbreaking Knee Cartilage Regeneration Treatments
Chronic knee pain can have lots of different causes, but the most common cause is damaged cartilage. Knee cartilage forms a thick, slick barrier to wear and tear inside the knee joint. When cartilage is healthy, your knees move effortlessly, without stiffness or painful friction. But if cartilage is worn or damaged, every step you take can cause significant discomfort. Before long, simple activities like climbing stairs or taking a daily walk are too uncomfortable to bear.
Not too long ago, repairing a knee with damaged cartilage meant one thing: knee replacement surgery. But today, there are other treatments designed to help cartilage repair itself and regenerate new tissue. Cartilage regeneration techniques can be very effective. However, they do require doctors with special training and a significant amount of skill to get the best results.
What is cartilage?
Cartilage is a tough tissue found in different parts of your body. There are different types of cartilage. The kind that lines your knee joints is called hyaline cartilage, but its also often referred to as articular cartilage. Thats because it helps your body articulate or move.
Can cartilage repair itself?
Worse, once cartilage starts to break down, the increase in friction inside the joint can cause additional cartilage damage. Thats why arthritis is called a degenerative disease without treatment, it tends to get worse over time.
What types of treatments can restore knee cartilage?
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Collagen And Protein Connection
Collagen is the main protein in cartilage, ligaments and bone. Your body makes collagen by combining amino acids1. Although your body can produce some amino acids on its own, others need to be derived from food. Focus on eating foods that are complete proteins, meaning that they contain all nine essential amino acids that the body can’t make. These foods include:
- red meat
- snow peas 4
Coaxing Knee Cartilage To Regrow
Technique Offers Long-Lasting Pain Relief, Delays Knee Replacement Surgery, Study Shows
March 9, 2006 — A new study shows that regrowing knee cartilage might help people delay knee-replacement surgery.
Cartilage covers the knee’s bones. With wear and tear, cartilage gradually softens, then cracks, and finally develops large holes. Without cartilage to serve as a shock absorber, knee bones rub against each other, causing pain and more damage.
The technique used in this study spurs knee cartilage to grow back, which could cut pain and improve knee function, write Kevin Stone, MD, and colleagues.
Stone’s study appears in The Journal of Arthroscopic and Related Surgery.
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Less Common Surgical Procedures
There are also a number of alternative surgical techniques sometimes used to treat cartilage damage, including:
- allograft osteochondral transplantation similar to mosaicplasty, but the replacement cartilage is obtained from a recently deceased donor, and is used to repair larger damaged areas
- autologous chondrocyte implantation the surgeon first takes a small sample of cartilage cells from the joint these are then used to grow more cells in a laboratory and the new cells are used to replace the damaged cartilage
- artificial scaffolds a special patch or gel is used to repair the damaged cartilage it may be used in combination with marrow stimulation or on its own
These procedures are only carried out in a few hospitals in the UK and are not routinely provided on the NHS. You may be able to pay for them privately, but they can be very expensive.
For more information about autologous chondrocyte implantation see:
Contrary To Popular Belief Cartilage In Human Joints Can Repair Itself Through A Process Similar To That Used By Creatures Such As Salamanders And Zebrafish To Regenerate Limbs Researchers At Duke Health Found This Process Could Be Harnessed As A Treatment For Osteoarthritis
Publishing in the journal Science Advances, the researchers identified a mechanism for cartilage repair that appears to be more robust in ankle joints and less so in hips. We believe that an understanding of this salamander-like regenerative capacity in humans, and the critically missing components of this regulatory circuit, could provide the foundation for new approaches to repair joint tissues and possibly whole human limbs, said senior author Virginia Byers Kraus, M.D., Ph.D., a professor in the departments of Medicine, Pathology and Orthopedic Surgery at Duke.
Kraus and colleagues, including lead author Ming-Feng Hsueh, Ph.D., devised a way to determine the age of proteins using internal molecular clocks integral to amino acids, which convert one form to another with predictable regularity.
Newly created proteins in tissue have few or no amino acid conversions older proteins have many. Understanding this process enabled the researchers to use sensitive mass spectrometry to identify when key proteins in human cartilage, including collagens, were young, middle-aged or old. They found that the age of cartilage largely depended on where it resided in the body. Cartilage in ankles is young, its middle-aged in the knee and old in the hips. This correlation between the age of human cartilage and its location in the body aligns with how limb repair occurs in certain animals, which more readily regenerate at the furthest tips, including the ends of legs or tails.
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What Is Articular Cartilage
The matrix of cartilage is made up of collagens, proteoglycans, and non-collagenous proteins. While cartilage is a highly-organized structure, about 85% of cartilage is water. This decreases to about 70% of older people. Chondrocytes are the only cells found in cartilage and this produces and maintains the cartilage matrix.
Articular cartilage serves as the cushion and shock absorber within the joint. It does so because it lines the ends of the two bones that form the joint.
Cartilage damage can be caused by several conditions including:
- Joint injury
- Rheumatoid arthritis
Joints affected by cartilage damage become painful, stiff, and have a limited range of motion.
Cartilage has a limited capacity to heal itself. Consequently, articular cartilage has become the focus of many researchers and tissue engineers who strive to be able to grow new cartilage and transplant it in place of damaged or worn cartilage.
Vitamin D And Osteoarthritis
Vitamin D is crucial for the development and maintenance of healthy bones. Adequate amounts enable proper absorption of calcium, which is necessary to support the structure and function of bones and teeth. It may also play a role in the prevention and treatment of cartilage deterioration, although using vitamin D for joint pain is unlikely to have immediate or verifiable results.
According to authors of a research review published in the Orthopaedic Journal of Sports Medicine in June 2017, vitamin D levels play a role in the development and progression of osteoarthritis. Their findings show that people with osteoarthritis typically have low levels of the nutrient, while individuals with sufficient blood levels have a lower risk of developing the condition and the associated cartilage degeneration.
The recommended daily intake for vitamin D is 600 international units for all adults. NIH reports that there are few dietary sources of vitamin D, which can make it difficult to get adequate amounts through diet alone. Your body can synthesize vitamin D from reactions within the skin when exposed to UVB rays from the sun. But due to widespread sunscreen use and less time outdoors, many people aren’t meeting the requirement.
You can increase your vitamin D stores by eating more fatty fish, such as salmon and tuna, and fortified milk, juice and cereal. If you think you are not meeting your vitamin D needs, speak with your doctor about whether you need a supplement.
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What Is Cartilage And Why Is It Relevant To Osteoarthritis
Cartilage, the smooth, rubber-like tissue found in crucial places throughout our body, cushions our bones from rubbing up against one another. This special tissue, which doesnt contain any nerves or blood vessels, helps our bones glide smoothly, hence why its absolutely crucial for our joints.
But while our bodies contain cartilage in many places, not all cartilage is created equal. For instance, the cartilage found in your ear and nose isnt the same as the cartilage in your knee joint. Not only do they have different purposes, the cartilage in your ear is much more flexible and elastic, while joint cartilage, also called hyaline or articular cartilage, is much more rigid. When that knee joint cartilage breaks down, it causes pain, swelling, and reduced range of motion, which ultimately results in osteoarthritis something you wont experience in your nose or ears.
Osteoarthritis has historically been referred to as wear-and-tear arthritis, as many believed it was caused by the slow weathering down of cartilage over time. However, doctors now understand that osteoarthritis is caused by many factors, including genetics, injury, weight, and overuse.
Other Preventative Measures To Protect Your Knee Cartilage Are Also Vital
Unfortunately, no matter walking or exercising, this will put wear and tear on knee cartilage. Your cartilage will lose cartilage cells and collagen matrix due to wear and tear. Although taking collagen supplements can help to strengthen and protect your knee cartilage, the ability for your body to repair or regrow cartilage declines as you age and cartilage loss is eventually inevitable. How can you protect your knee cartilage if cartilage loss is inevitable? Whether you have to accept declining joint health? The answer is definitely not! Physical therapy or wearing knee pads can be alternative solutions to help you to reduce knee pressure. Hence it will be less wear and tear that your knee cartilage will suffer. The newly invented spring-loaded knee joint support pads can help you to reduce the pressure on your knees effectively.
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Immobility Or Reduced Activity
Just like the muscles, cartilage should be put into constant use to maintain them in a healthy condition.
In situations such as chronic diseases where people are bedridden, or in paralysis where the individual cant put the affected joint to use, cartilage begins to reduce in size and degenerate a process called atrophy.
Nowadays, advancements in medicine and scientific knowledge have made it easier to understand how new cartilage can be produced.
Lets take a look at how that occurs.
Knee Cartilage Repair Regeneration And Replacement
There are two primary types of cartilage in the knee: articular cartilage and meniscus . SeeSoft Tissue of the Knee Joint
These surgeries can be performed on almost any joint, but they are most commonly performed on knees. They are generally appropriate for people who have specific cartilage injuries rather than widespread cartilage damage, like that found in moderate to severe knee arthritis.
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Osteoarticular Transfer System Procedure
The OATS procedure, also called mosaicplasty, involves taking healthy cartilage from non-weight-bearing areas of the joint and transplanting it into the damaged areas. Because the transfer happens within the same joint, this procedure works best for small areas of damaged cartilage. Joints significantly affected by osteoarthritis may require a different approach. Since your own tissue is used, the OATS procedure eliminates risks related to allergy or transplant rejection.