articular repair

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The cartilage covering the bone ends is very special and once lost does not regenerate.  This provides a natural bearing surface to joints and when healthy is slippier than ice with extremely low friction.

Assuming there is no issue with the overall alignment or ligaments of the knee, techniques have been developed to help stimulate some form of cartilage covering through traumatic and sometimes degenerative exposed bone.  The size of the lesion tends to dictate the treatment options.

Microfracture

For small lesions sometimes just abrading the surface can allow some bleeding from the exposed bone which sets the healing process off.  However for small lesions, it has been shown that encouraging the body’s own marrow on to the exposed bony surface can help healing.  Sharp “picks” are driven few millimetres into the exposed bony surface at low energy.  This gives rise to breaches in the hardened or subchondral bone.  Cells are able to reach the exposed bony surface and this leads to a fibrocartilage formation.  For larger lesions, we aim to try and replace or regenerate true articular or hyaline cartilage as it is termed.

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