The cartilage in joints performs a very important function: it acts as a cushion between the moving parts of a joint, absorbing the shock of high-impact movements, helping the joint move more smoothly, and providing additional stability. Damage to the cartilage of a joint can severely reduce mobility, and cause significant pain. Cartilage repair surgery helps to preserve the joint's structure and function, and reduces pain and other symptoms too.
Cartilage is tough and flexible, but it's a type of tissue that has a poor blood supply. This means that when it's injured in some way, it doesn't repair itself very easily. Cartilage is vulnerable to certain kinds of injuries, in particular, injuries caused by high-impact twisting movements. Cartilage also becomes more likely to tear as we age, because it loses flexibility and is more prone to injury. In addition, simple wear-and-tear from normal everyday movement and activities causes slow but unavoidable damage to joint cartilage.
Any one of these injuries or situations can lead to the degeneration of the cartilage that cushions a particular joint. The joints that are most vulnerable are the hip and knee joints, because they're the joints that take most of our weight when we walk and perform other activities.
When cartilage deteriorates due to injury or wear-and-tear, the joint no longer has the cushioning it needs to move smoothly. The results is that moving the joint may start to cause significant pain, the joint becomes stiff and less able to move freely. Aside from the pain, the most significant problem people experience is a loss of mobility.
Minor and moderate injuries to cartilage can often be repaired with an extended period of rest, medication to relieve pain and inflammation, and rehabilitation exercises. However, not all cartilage injuries can be effectively treated this way. Extensive injuries to the cartilage are more difficult to treat because of the limited blood supply.
If a cartilage injury is large or unstable—meaning it continues to get worse over time—then surgery is often the best way to repair the damage. Whenever possible, cartilage repair surgery is carried out using a surgical technique called arthroscopy. In this kind of surgery a surgeon uses a miniature camera and surgical instruments to repair the damage via small incisions in the treatment area. This technique is less invasive than open surgery, and the recovery time is shorter. However, for larger cartilage defects limited open surgery may be required.
Surgeons use several different surgical techniques to repair cartilage. For instance, one technique is called microfracture. Here, the surgeon removes damaged cartilage, and then uses a surgical instrument to make tiny holes in the bone underneath. This stimulates the growth of new cartilage, and at the same time provides the new cartilage with a temporary blood supply to provide nutrients for growth. This can be combined with platelet rich plasma or the patients own stem cells.
After cartilage repair surgery, it's vital to provide the joint with support and protection in order to allow the cartilage to heal properly. Depending on the joint that was repaired, this might mean using a mobility aid such as crutches or a leg brace for several weeks after surgery. Most people will also be prescribed some kind of physical therapy to strengthen the leg muscles and improve the mobility of the joint.
After cartilage surgery the tissue is still vulnerable to further damage, so it's important to be mindful of this, and to continue to take care of the joint to reduce the risk of this happening. We will then have a discussion about when it is safe to resume back to your usual level of activity.
Other risks are stiffness, numbness, thrombosis and re rupture. However, would good post operative care and guided physio therapy these risks can be kept to a minimum.
I am writing to thanks you & your staff fro the wonderful work you did on my hip repllacement. It is so nice not to be in constant pain and it's enjoy able to go for a walk now & not dread it as before. I can't thank you + the staff at the cavell hospital enough.
After years of arthritic pain, steroid injections, physiotherapy and arthroscopy (which actually made things far worse)... I now feel like a new woman thanks to the knee surgery you performed last month - I have no doubt this is due in no small part to your skill as a surgeon. The wound healed quickly, recovery has been rapid, without any complications and the scar is neat and beautifully stitched!!
Having recently undergone a full left knee replacement I am 100% satisfied with everything Mr Saksena and his team at The Cavell provided. I was given plenty of advice both before and after my surgery, which was very reassuring. My recovery has been rapid with minimal pain and within 8 weeks I had full extension and 130 degree flexion back in the knee. I wouldn't hesitate to recommend Mr Saksena as an orthopaedic surgeon.
I had a total knee replacement with Valgus Deformity 7 weeks ago, and this gave the surgeon extra work to do, I only have good things to say about this surgery and after care with all staff involved at Chase Farm Hospital, as in my experience I have heard a lot of good and bad things about this type of surgery, Well I can only say that if anyone has concerns about this please try not to worry it is worth while as it has given me a new lease of life to what I had before, and yes the first 2 weeks are the worse, but please do try your exercises, because as they say you only get the real benefit if you are prepared to do your bit. Thanks very much for my new lease of life yet again.
I was very fortunate to be referred to Mr Saksena as an NHS patient and was very impressed with the treatment and care provided by Mr Saksena and the whole team at Cavell Hospital. Once discharged, someone was always available to talk to you and an appointment was made immediately if you needed to see a nurse (which I did several times, due to a normal discharge from my wound). The entire staff were all friendly, cheerful and efficient. The scar is very neat and after 7 weeks I am walking well and just using a stick outdoors.
I would like to just sincerely thank you for the job you did on my knees, both of them. Before I had my knees replaced I was in constant pain, which had been the case for nearly 5 years. It was so bad that I often wondered what the use was in living! Now, nearly 2 years later, I feel I have my life back. I can now walk without pain and every single day, and I mean every single day, I walk the roads that I walked pre-operations and I remember the pain that I was in for every small distance I had to walk. Now, I walk with a smile on my face and a thrill in my heart, so very grateful for having the freedom to enjoy walking once again. I also have great fun going with the grandchildren to the park and playing with them, which before the operation was impossible as all I could do was basically sit and supervise them. So there too there is a huge change.
You did a total knee replacement on my right leg on 22nd March in the Kings Oak Hospital and it has been very successful. I am now almost pain free with the knee getting stronger each day. I would like to thank you and your excellent medical team for doing such a neat job. I would also like to thank the wonderful nurses at the hospital who were always cheerful and efficient.
In September 2014 I underwent a knee replacement operation. Mr Saksensa was an amiable professional with a calming influence and caring nature. His team were friendly and supportive. My knee replacement was a complete success and I am still enjoying my favourite sport of skiing.
You performed a partial meniscectomy at Highgate Hospital in late april. I would like to thank you for your hardwork; the problem has been entirely resolved and I am pretty sure that is down to the procedure rather than the passage of time as the condition persisted during the prior two months. Some part of that is surely down to your skill.