Advances in cartilage repair lead to quicker healing time

During last year’s season opener against the New York Giants, Dez Bryant, wide receiver for the Dallas Cowboys, broke his right foot. As ESPN reported, the injury dramatically impacted his play, putting him on the sidelines for weeks and leading to a host of surgeries — including a stem-cell injection to help his foot heal. In the end, Bryant made a full recovery and is back on the field for the 2016-17 season.

A stem-cell injection might seem like a high-end, sci-fi technique, but it’s increasingly common in clinics — including ours — to use the procedure with cartilage repair. With bone marrow aspirate concentrate (or BMAC for short), we can shorten healing times in non unions of fractures, difficult fusion, or healing of cartilage lesion in the ankle. How does it work? The patient supplies his or her own bone marrow, which is harvested from the hip joint, centrifuged, and inserted into the problem area. The end product is rich in stem cells and growth factors that contribute to healing, so once it’s injected, the cells go right to work.

Platelet-rich plasma injections, sometimes referred to as PRP injections, are another option for quicker recovery. PRP injections use a patient’s own blood to stimulate healing. Platelets are the body’s natural way to grow new tissue and repair injuries, so PRP kicks it up a notch by supplementing platelet content and speeding up the healing process. Blood is withdrawn and, through centrifuge, separated to concentrate the platelets. The plasma is up to five times more concentrated with platelets than natural blood. Once the platelets are inserted into the problem area, recovery is quick and it can take less than two months to see full benefits.

Of course, these treatments don’t stand alone, and there are advanced techniques for cartilage repair that are used in conjunction with BMAC and PRP. Bone marrow stimulation is one such option, though it is best for younger adults who are active and have a focal cartilage injury or lesion. It’s commonly performed on athletes who may have sustained injuries during play. Bone marrow stimulation is considered an arthroscopic procedure, and it works by creating tiny fractures in the underlying bone. As blood and bone marrow begin to form, a super clot of growth factors develops, leading to new cartilage. Although the procedure requires anesthesia, most patients head home the same day and, with physical therapy, return to sports after six months of healing.

Cartilage transplants are another option. Osteochondral allograft transplants replace damaged cartilage with the healthy cartilage from a donor cadaver. This method helps delay or prevent the onset of arthritis and can both relieve pain and restore movement and function to a joint. Similarly, juvenile allograft transplants replace worn or injured cartilage with that of a donor, but the key difference is the level of chondrocytes, or healthy cartilage cells, that are transferred over. Since juvenile tissue has higher levels of these healthy cells, the joint has a better chance of healing.

The options for cartilage repair can seem overwhelming. If you’re a candidate for repair, call or stop in to discuss your treatment choices.

Posted in: Achilles Tendon, Ankle, Foot Health

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Dr. Hubbard’s goal as a Foot and Ankle Surgeon is to provide expertise in achieving an accurate diagnosis, implementing exceptional surgical technique whenever indicated, and most importantly, utilizing practical judgment to devise an effective individualized treatment plan that will restore the patient’s foot or ankle health and function, improving their overall quality of life.

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