Knee Pain? Newest and Most Cutting-Edge Techniques Now Available in the Jersey Shore Area

By Ryan J. Plyler, MD

If you are experiencing chronic knee pain, you now have more options than ever. Advances in orthopaedics are allowing specialty-trained surgeons to actually preserve your joints by restoring or transplanting your cartilage!

What is joint preservation surgery?

Joint preservation is just as it sounds. It is surgery to repair the torn cartilage or other tissues in the knee, avoiding the need for joint replacement surgery. But what exactly does that mean? To completely understand the options that now exist, we have to address each issue individually. If you have more than one of the following, you can still be a candidate for joint preservation surgery, but you may require more than one procedure to achieve the optimal result for your knee.

I had most of my meniscus removed in the past and am now having pain. What now?

If you have had previous meniscal repair surgery that has failed or have had part of your meniscus removed and now find that you have continued pain on that side, you may be a candidate for joint preservation surgery. Depending on the overall health of your knee on MRI, you may be a candidate for a meniscal transplantation surgery. During this surgery, three small incisions are used to insert a new meniscus into your knee to serve as a new shock absorber when you walk and run. The limitations after this surgery are much more minor than those associated with a joint replacement.

I have an area of my cartilage that is thinning and causing my pain?

If you have a defect of the cartilage in your knee in any location, including the femur (thighbone), tibia (shin bone), or patella (kneecap), you may be a candidate for joint preservation surgery. If the cartilage defect is small, then it may benefit from a small surgery to clean up the edges. However, if the cartilage defect is large, you may be a candidate for MACI (matrix autologous chondrocyte implantation).

What is MACI?

MACI is a new surgery that allows an individual to grow their own cartilage cells and have them placed back into their knee to fill a defect. In the first stage, a small surgery is performed to clean up the torn cartilage, and a biopsy of your cartilage is taken and sent to a lab (Vericel, Boston, Massachusetts). Your cartilage cells are grown until there are millions of your own cartilage cells available, and they are then placed onto a collagen membrane. During the second surgery, your own cartilage cells are stitched and glued back into your knee to fill the cartilage defect. The cartilage cells grow to fill the defect over a 6- to 12-month period. After this rehab process, you are able to return to all activities without restrictions.  

Am I a candidate for joint preservation surgery?

At this time, these procedures are approved for individuals 50 years and younger with an otherwise healthy knee. I like to say that it is like fixing a “pothole on a good road.” Sadly, knees that have already developed substantial amounts of arthritis are not candidates for this type of joint preservation surgery. These individuals are better suited with a total replacement. However, I am excited to be bringing the newest and most cutting-edge surgical procedures to the Jersey Shore region. I am committed to providing the best possible orthopaedic care to my patients, and I will continue to utilize the most advanced and revolutionary surgical techniques to provide optimal outcomes for my community.