Knee Arthritis Treatment Advances

The good news is that because osteoarthritis is affecting more and more people, there is more money to be made so more is spent on research.

Around the world, scientists are all looking for the 'Holy Grail' of osteoarthritis treatment - the ability to re-grow articular cartilage.

The bad news is that despite much effort, we are still some way off a simple solution.

Autologous Chondrocyte Implanting is currently being used to treat areas lacking articular cartilage. This involves multiple operations. Firstly some cartilage cells are harvested via key hole surgery. These are grown in a laboratory before being implanted to cover the defect in the second procedure. Results vary depending on the size and location of the original lesion. It is also costly, and has a lengthy rehabilitation.

Scientists are looking for a simple way to re-grow cartilage. One that can be administered via injection or a single operation.

A new study out of the U.S. has had some promising results using a nanofiber gel in combination with a microfracture technique. The success has so far only been achieved on animal models but it offers hope for the future. This type of treatment is minimally invasive and just what we are looking for. Lets hope the follow up studies are positive as well.

See the full article here.

Knee Cartilage or Meniscus?

Is knee cartilage the same as the meniscus?

This is a common area of confusion when discussion knee problems with a doctor. The confusion is due to doctors using different terms to everyday people.

From a doctors point of view, you have both in your knee. Hopefully anyway.

What is a meniscus?

You have two menisci in each knee. One on the inside of the knee (medial meniscus) and one on the outside (lateral meniscus). Each is a roughly 'C' shaped piece of cartilage that acts as a shock absorber. It has a wedge shape when profiled that helps to contribute to joint stability. The meniscus can be torn by twisting activities and is a common sports injury. This is commonly called a 'torn cartilage'.

What does a doctor mean by cartilage?

To avoid confusion (among themselves only it appears) doctors always refer to 'meniscus' when appropriate, saving the word 'cartilage' for use when discussing Articular Cartilage.

Articular cartilage is the smooth lining of our joints that allows us to move freely without pain, over many years and while weight bearing. As you can imagine, to do this task it is very hard and does not tear like a meniscus. It does however wear away over time or as a result of injury. This wearing the articular cartilage is what we call osteoarthritis.

Are they linked?

Since the meniscus protects the joint by absorbing shock, any injury to it that results in its full or partial removal during surgery increases the risk of osteoarthritis.

These two structurally different types of cartilage work as a team to allow movement and protect the bones of the leg. Losing one or both can have serious consequences.

Hyaluronic Acid - Can it help after Arthroscopy?

Hyaluronic Acid has been shown to have limited success when used in isolation to treat osteoarthritis. It helps some but not all people, and its benefits may be short lived.

A new study has looked at the use of Hyaluronic Acid after knee arthroscopy. The results of a Weill Medical College investigation showed that patients receiving a series of three injections after their knee surgery had less pain and increased mobility on follow up at 3 and 6 months.

Points to consider:

Knee arthroscopy for osteoarthritis has been shown to be of little benefit unless mechanical symptoms of meniscal tears exist.

The study was limited by a small sample size. A much larger study is required before any benefit can be confirmed.

Having three injections after surgery is likely to slightly increase the risk of infection. Any benefit would need to be large enough to offset this increased risk.


It will be interesting to see what future research reveals.