Arthroscopic operations for arthrosis and damaged cartilage
Cartilage damage can occur in the knee as a result of injury, overexertion or due to mechanical functions. Four stages can be differentiated:
- swollen cartilage
- frayed cartilag
- undermined and ruptured cartilage
- complete absence of cartilage
Cartilage damage can occur on the cartilaginous joint surfaces of the thigh and shines through mechanical disturbance caused by an old meniscus tear. Minimal incarcerations of meniscus particles between the joint surfaces cause fraying, which can progress to complete abrasion of the cartilaginous surface. The prognosis, with regard to load-bearing capacity and freedom from symptoms following arthroscopic operation of a meniscus, depends on the damage caused to the cartilage by the injury.
Frayed and shredded cartilage is smoothed using special arthroscopic cutting instruments with a vacuum function. All loose particles are sucked out of the joint. Depending on the extent of the findings, the patient needs elbow crutches to keep the weight off the leg for 1 – 4 weeks following the arthroscopic operation.
If there is already complete abrasion of the joint cartilage, treatment involves freeing the bone from dead superficial tissue in order to trigger cartilage production. Using a surgical shaving instrument the bone is superficially shaved until the blood supply to the bone is visible. This is the only method that facilitates the development of new cartilage-like tissue from within the depth of the shaved bone in 3-6 months, and which is capable of taking over much of the function of the lost joint cartilage. In order to allow the covering layer to become as thick and durable as possible the patient has to use elbow crutches for approx. 6 weeks following the arthroscopic operation. This means that the operated knee only carries out walking movements without taking any weight. We will teach you how to walk using crutches and are sure that you will find it simple to learn.
Production of replacement fibrocartilage (microfracture according to Steadman, subchondral abrasion, Pridie drilling):
In the case of complete cartilage lesion of the subchondral bone the aim of the repair process is to provide fibrocartilage cover for the damaged chondral surface. Perforation of the hard bone layer causes blood and bone marrow cells to flow into the damaged cartilage. Some of the released cells are pluripotent i.e. undefined, and still able develop into specialist cells. The direction of their development is determined by the nature of the surrounding area. This means that in an area of damaged cartilage the cells receive information to become cartilage cells and then produce new, replacement fibrocartilage. The type of cartilage damage determines which process is applied.
Please contact our team if you have any questions