Ask the Expert: Dr. Anil Ranawat, Orthopedic Surgeon, Answers Your Questions About Cartilage Injuries
Q1. Can you talk about the current status of artificial cartilage? I had knee surgery 20+ years ago and they removed cartilage from my left knee and now I am in so much pain!
People often confuse cartilage and meniscus. The former is coating at the end of bone that has a high water content that helps joints glide against each other while the latter is made of fibrocartilage and its primarily role is to protect cartilage from early failure. We have new technologies to replace and restore both of them to prolong the longevity of the knee such as osetochondral autograft, autlogoous cartilage implantation as well as mensical allografts.
Q2. I would love to know how to keep what little joints I have left. I am down to 2 good ankles and 1 elbow, and the rest of me is totally shot. I just had a total hip replacement and waiting on a right knee replacement, right elbow and back surgery. I was checked for RA, comes back negative. What could be causing my joints to destroy themselves? I also need both shoulders.
There are three basic forms of arthritis. One is osteoarthritis which is a gradual decline in cartilage with time. The other is inflammatory arthritis which occurs in younger people when the body’s own immune system attacks itself like rheumatoid arthritis and the last is post-traumatic arthritis which is a result from a trauma to a joint. It is best to have this evaluated by your treating physician.
Q3. Does PRP play any role in cartilage injuries?
Although many people are trying, the data is limited. They are best used for muscle tendon injuries.
Q4. What is the current research on cartilage injuries?
There are numerous new technologies using advances in autologous chondrocyte implantation, juvenile cartilage and minced cartilage. There are pros and cons to all of these and depend on the patients and surgeon’s experience.
Q5. I have cartilage knee damage and may need transplanted tissue. Is this common? Are most patients able to return to athletic activity?
This is very common. Most individuals are able to return to high level sports after an anterior cruciate reconstruction (allograft transplantation). Individuals can also be active after meniscal and osteochondral allograft depending on associated injuries.
Dr. Anil Ranawat is an HSS orthopedic surgeon and assistant team physician for the New York Mets. His clinical and research interests are focused on joint-preservation surgery of the knee and hip, robotic surgery, partial knee replacement and mobile-bearing technology.