Cartilage Repair Offers Hope for Athletes Struggling with Knee Pain

A mid-50s competitive golfer faced persistent knee pain despite various treatments, prompting him to seek advanced options for cartilage repair. After exhausting non-surgical treatments such as physiotherapy and injections, he turned to Dr. Francis Wong Keng Lin, an orthopaedic surgeon-scientist at the Oxford Cartilage & Sports Centre in Singapore. The patient underwent cartilage repair and meniscus surgery, leading to a significant improvement in his quality of life and ability to engage in sports.

Treatment Options for Cartilage Damage

Cartilage damage can severely affect mobility. Dr. Wong explains that treatment options vary widely, including conservative approaches like physical therapy and over-the-counter medications. For more severe cases, intermediate treatments such as hyaluronic acid injections or invasive procedures like debridement and cartilage repair surgery may be necessary.

When formulating a treatment plan, Dr. Wong emphasizes the importance of a holistic approach. This includes evaluating the patient’s activity level, medical history, and personal expectations alongside the severity of the cartilage damage. He highlights the preference for cartilage-preserving procedures, such as knee cartilage repair, over knee replacement, as they maintain the natural joint structure and maximize future treatment options.

Many patients prefer minimally invasive techniques, such as keyhole surgery, which reduces muscle and tendon injury, ultimately allowing for quicker recovery.

Understanding the Microfracture Technique

One of the earlier methods for addressing cartilage damage is the microfracture technique. This procedure involves creating small holes in the bone to stimulate healing. According to Dr. Wong, while microfracture is widely available and cost-effective, it comes with challenges, particularly during recovery. Patients are advised to avoid weight-bearing activities for up to nine months following the surgery.

“Once a microfracture is performed, the subchondral bone may have poorer response to subsequent cartilage treatments,” Dr. Wong noted.

Potential risks associated with microfracture include damage to the subchondral bone, which supports the cartilage, and the development of cysts or bone spurs that can worsen the condition. Research indicates that the cartilage formed through this method may be lower in quality, leading to further joint pain within two years.

To address these issues, Dr. Wong has adopted newer techniques that enhance the body’s natural healing processes.

Innovative Approaches to Cartilage Repair

Dr. Wong employs a technique that promotes cartilage regeneration by preparing the bone surface to allow for small punctate bleeding from the bone marrow. He uses a biodegradable scaffold made from hyaluronic acid fibres, such as Hyalofast, to fill the damaged area. This scaffold acts as a framework for new cartilage growth by capturing the healing cells released from the bone marrow.

In the case of the golfer, Dr. Wong utilized the Hyalofast scaffold, which facilitated a less restrictive recovery process. The patient was able to return to competitive tournaments within six months of surgery.

For many, successful cartilage repair not only restores mobility but also allows individuals to engage in activities they love. Dr. Wong has seen patients return to sports without issues, including a young basketball player who resumed competitive training just six months post-surgery.

Post-operative rehabilitation focuses on rebuilding strength, range of motion, and balance. Dr. Wong recommends activities such as resistance training, yoga, and reformer pilates. He encourages individuals unsure of how to proceed to consult with their orthopaedic doctor or physiotherapist for personalized guidance on improving musculoskeletal health.

For those suffering from knee pain, discussing treatment options with a qualified orthopaedic surgeon can lead to significant improvements in both mobility and overall quality of life.