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Author Topic: Simple question - Can damaged cartilage repair and regenerate itself?  (Read 22804 times)

Offline supersi

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I have been to see several specialists (Ortho, Phsyio and Sports Physician) with my mal tracking patella and associated issues.

I have read a number of posts on this site and articles in sports and medical publications.

Most seem to say that damaged cartilage will not heal itself. Once it is damaged it is damaged for life.

Other's say it can repair itself eg, http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=53006.0

Can damaged cartilage repair and regenerate itself?

supersi
R Knee:

12/06/10 Diagnosed with high grade chondromalacia, lateral trochlea dysplasia, patella alta and fat pad impingement

Offline kscope09

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Re: Simple question - Can damaged cartilage repair and regenerate itself?
« Reply #1 on: September 23, 2010, 10:41:01 AM »
There are surgical treatments like chrondoplasty, microfracture, OATS, ACI etc,.  Glucosamine ight help slow down the loss of cartliage, but no you will never regrow cartliage on your own
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Vickster

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Re: Simple question - Can damaged cartilage repair and regenerate itself?
« Reply #2 on: September 23, 2010, 02:46:25 PM »
You can grow fibrocartilage yourself (not everyone does though) - this is what happened to me when I knocked a chunk off the femoral condyle - would have been Grade IV and now filled with scar tissue.  It is not a painfree surface however [it is tender to prod) and I have constant swelling, can't kneel or squat (but also have damage on patella).  I also don't anticipate it will outlast the rest of me as the FC is not as good as the original smooth hyaline cartilage which cannot be regenerated as yet (even MACI/ACI only produce hyaline-like, while OATS uses hyaline from elsewhere, so you end up with fibro at the donor site, normally non WB)

I expect on the patella it is less likely due to the shearing forces, would just get worn away again
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
Partial meniscectomy, mfx not needed - smooth scar tissue over OC lesion, shaving of grade III defect lateral aspect of patella
2nd scope on 16/12/10, chondroplasty & Durolane jab
New MRI shows lat meniscus tear & other stuff
Ostenil plus jab

Offline ashok_guru

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Re: Simple question - Can damaged cartilage repair and regenerate itself?
« Reply #3 on: September 23, 2010, 02:59:46 PM »
Please follow this thread it talks about cartilage regeneration using PRP, Prolotherapy, Prolozone, HGH and stemcell treatment

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=46074.195

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47512.0
2009 - Partial Meniscetomy
2010 - Cartilage Debridement
2010 - 2011 - Prolotherapy, PRP, Bone Marrow Prolotherapy, Prolozone
2011 - Regenexx-PL, Regenexx SD and Regenexx-SCP
2012 - HGH Injections
2013 - Regenexx-PL, Regenexx SD, Regenexx-AD and Regenexx-SCP

Offline kscope09

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Re: Simple question - Can damaged cartilage repair and regenerate itself?
« Reply #4 on: September 23, 2010, 04:28:19 PM »
Yes! youncan grow fibrocartliage though it doesn't always worked out and Vickster is right; it is basically scar tissue with chrondocytes in.  You can't grow this kind of thing on your own thoug, you would need a microfracture.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Lottiefox

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Re: Simple question - Can damaged cartilage repair and regenerate itself?
« Reply #5 on: September 23, 2010, 06:48:00 PM »
You can't grow this kind of thing on your own thoug, you would need a microfracture.

Sorry but this is wrong - you CAN grown scar cartilage (Fibro) without a MFX. Some people do, some people don't. In a traumatic loss of cartilage some people may sponteneously fill the defect with scar tissue as the body tries to heal. For some people this works, and many people may never know they have a defect (until the scar tissue fails - if it does). Others won't and will be left with a defect that can be of varying depths and with varying effects on their life. Cartilage itself has no pain endings, so the pain you feel doesn't come from it directly. There have been studies showing that people do generate fibro across wider areas of damage (eg PFS thinning) but again, research is patchy and it will never be the same as your own hyaline cartilage. Sometimes the key is not the holy grail of new cartilage but helping the joint function strongly and stably so that the bare areas or scarred areas aren't as troublesome.

Movement of the joint will always nourish the remaining cartilage - hence use it or lose it....(within reason!)

Lottie
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline kscope09

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Re: Simple question - Can damaged cartilage repair and regenerate itself?
« Reply #6 on: September 23, 2010, 10:07:28 PM »
Wo!  No way!  But how does it do it without drilling holes in the bone that caause bleeding that turns into a scab that then turns into fibrocartlaige?  Does it come from the synovial fluid?  Does it ahve chrondocytes in it?  Is it as good as an mfx?  could you grow more if the original scar tissue fails?

That's genuinely amazing! Sorry I charged in without the right facts.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Lottiefox

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Re: Simple question - Can damaged cartilage repair and regenerate itself?
« Reply #7 on: September 23, 2010, 10:53:03 PM »
kscope

I have no clue how it happens but it can do - as Vicks said, her defect filled in of its own accord. I guess the body sometimes tries to heal itself but if it doesn't then MFX is a way of forcing the defect to try and fill in with something. I think your questions are good ones, and I would guess even cartilage gurus don't know the answers., Its such a new science and is growing all the time. I know on my Grade 4 defect when I did it, I had terrible awful stabbing ice pick pain on the day, a joint line that I simply could not touch it was so tender, and then the next time I tried to run (not knowing what I'd done) I nearly threw up the pain was so intense. 12 months on the knee has had no surgery but the defect must have something on it, as the pain has changed and only happens at a certain angle and not with walking or impact activity. Its still a grade 4 defect on MRIs but something must have happened to reduce that ice pick pain. Long may it continue....

Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline kscope09

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Re: Simple question - Can damaged cartilage repair and regenerate itself?
« Reply #8 on: September 23, 2010, 11:54:52 PM »
Since scar tissue doesn't show up on mri then it could explain things.

I was the opposite though, my defect never showed on on mri even though it was full thickness.  The OS said it was like a pinhole where the cartliage had been puncturd as a result of tearing the acl.

I had medial pain but it wasn't horribly bad all the time, but it did get me at some angles.  Infact I did have terrible medial pain originally which seemed to get better with pt and then came back with avengence the year later, which is why I had the scope.

I can't believe that I could have had that defect on my mfc for a possible 18 months without it getting bigger.  In fact my pt can't believe it either, so I wonder if maybe it did get filled in its self for a while.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline jt801

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Re: Simple question - Can damaged cartilage repair and regenerate itself?
« Reply #9 on: September 24, 2010, 03:08:19 AM »
I read something about this a while back and the gist of it was that in some cases the body moves the stem cells itself through the bone and into the defect area in an effort to heal. Another point made was that it frequently takes place where the bone has been damaged as well thus creating an area where the bone marrow and stem cells have been exposed. I dont believe that its nearly as effective compared to mfx because the calcified cartilage that interferes with healing has not been removed and the area has not been prepared as it would be during surgery. Also, the number of stem cells released is not nearly the same as when the subchondral bone is perforated by the mfx and its much more random. From what i understand, in the limited number of people in which this occurs its pretty much a desperate attempt by their body to try to heal itself in an injury situation where normal healing techniques don't take place.
« Last Edit: September 24, 2010, 03:11:38 AM by jt801 »
12/99 left knee lateral release and plica removal
1/09 right knee chondroplasty and microfracture LFC

Offline Vickster

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Re: Simple question - Can damaged cartilage repair and regenerate itself?
« Reply #10 on: September 24, 2010, 08:04:39 AM »
kscope - as Lottie said, my defect (which did show up on initial MRI and X-Ray and can be seen on the latest MRI as filled) did fill without mfx or drilling - some people (like me evidently) can build fibro without intervention and others cannot - and it's not a small pinhole either, 1.5cm2 (not huge of course).  That I had fibro wasn't known until I had the scope (but that was 5 months post injury) - the OS went in with a view to possibly need to drill but didn't as the hole was filled well enough.  It has settled to some degree but still have pain and swelling.  Not enough to go down the MACI route according to the OS I saw for second opinion.  I was actually going to have AMIC yesterday  :o but the insurance company wouldn't cover.  Actually, rather glad I didn't as the knee is more bearable now than when initially decided! OS decided there would be no point in debriding and microfracturing as I could just end up in the same situation with tenderness (I guess this could be an option of the fibro disintegrates).  What I don't truly get is the need to be NWB completely post MFX, I hobble around on my defect and it filled  ???  My OS is also pretty anti-OATS in my situation

I don't know what the future holds for the defect which is in a WB area laterally and connects with the ground when I kneel (hence I can't comfortably) - my OS is unable to give any sort of timescale for how long the fibro will last, but I try to avoid annoying it and am trying to keep leg muscles strong
« Last Edit: September 24, 2010, 08:33:28 AM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
Partial meniscectomy, mfx not needed - smooth scar tissue over OC lesion, shaving of grade III defect lateral aspect of patella
2nd scope on 16/12/10, chondroplasty & Durolane jab
New MRI shows lat meniscus tear & other stuff
Ostenil plus jab

Offline andyek

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Re: Simple question - Can damaged cartilage repair and regenerate itself?
« Reply #11 on: October 19, 2010, 02:32:17 AM »
It has been successful in the young, growing in a test tube and transplanting to the knee.  You can google the procedure for age limitations.  I also used a company called Biona Care, which uses electrical stimulation when you sleep.  It did not work for me, but has helped some.  I was in an FDA test group, 3 months a placebo and 9 months the actual electrical charge, no change in me.

Offline papasmurf1978

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Hi everyone who posted here.

A little about myself. I have been diagnosed with beginner stage of chondromalacia patella via MRI test. My orthopedist said that the signal they saw is so small 6 mm large x 4 mm high affecting less than 50% of my cartilage that he guarantees me I will not need a knee replacement later in life. I`m 36, male. He said with good physio I will help me knees to stay healthy for long time.

A very good question posted here if knee cartilage can regenerate. Technically no unless it goes all the way to the bone and then a similar type collagen is excited to be produced by the bone but it`s not even close to the real hyaline like collagen.

Is there hope for cartilage defects today? YES!!!!!!!! I stumbled upon an article describing German pharmaceutical company that invented a gel substance that can regenerate cartilage in any defect. Product is called Chodrofiller. Here's the link to the article:
http://www.sciencedaily.com/releases/2014/04/140428074648.htm

It seems all it takes is a minisurgery to get the needle in and patch the defect and in relatively short time cartilage starts to regenerate with the surrounding cartilage and according to once preclinical trial, it took less than 6 months for the MRI to reveal the patched cartilage defect no different than surrounding tissue.  It might be the big thing in science as other procedures are available but me personally I don't want to get ACI treatment and have two surgeries and year of rehab.

Check it out guys, let us know what you think.

Cheers and good luck to everyone!
August 2014 MRI:
Mild Chondromalacia Patella in both knees
Normal cartilage thickness in both knee caps

Offline papasmurf1978

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Here's the link to get more info on the product Chondrofiller:

http://www.amedrix.de/index.php?option=com_content&view=article&id=23&Itemid=130&lang=en
August 2014 MRI:
Mild Chondromalacia Patella in both knees
Normal cartilage thickness in both knee caps

Offline MDAL

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kscope - as Lottie said, my defect (which did show up on initial MRI and X-Ray and can be seen on the latest MRI as filled) did fill without mfx or drilling - some people (like me evidently) can build fibro without intervention and others cannot - and it's not a small pinhole either, 1.5cm2 (not huge of course).  That I had fibro wasn't known until I had the scope (but that was 5 months post injury) - the OS went in with a view to possibly need to drill but didn't as the hole was filled well enough.  It has settled to some degree but still have pain and swelling.  Not enough to go down the MACI route according to the OS I saw for second opinion.  I was actually going to have AMIC yesterday  :o but the insurance company wouldn't cover.  Actually, rather glad I didn't as the knee is more bearable now than when initially decided! OS decided there would be no point in debriding and microfracturing as I could just end up in the same situation with tenderness (I guess this could be an option of the fibro disintegrates).  What I don't truly get is the need to be NWB completely post MFX, I hobble around on my defect and it filled  ???  My OS is also pretty anti-OATS in my situation

I don't know what the future holds for the defect which is in a WB area laterally and connects with the ground when I kneel (hence I can't comfortably) - my OS is unable to give any sort of timescale for how long the fibro will last, but I try to avoid annoying it and am trying to keep leg muscles strong


This is true, you can regrow naturally, (by naturally, I mean having a bone fracture that will bleed out bone marrow), which is similar to the process in which microfracture works...

I suppose that in the initial stages once bones start rubbing against each other we all produce some, which will eventually break out... but in the end, a bone spur will win...

But about the original questions, unless you are very young (in growing age), while your natural growth hormones that allow your cartilage to grow along with with your bones, you won't heal on yourself... a child in growth age, could eventually heal from an injury by its own regeneration/growth capacity (young cells, plenty of stem cells and high levels of growth hormones).

EDIT: Last paragraph is related to building something close to hyaline cartilage, not fibro-cartilage.
« Last Edit: June 01, 2014, 02:36:27 AM by MDAL »

 















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