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The BioCartilage knee repair and the DeNovo knee repair techniques might be appropriate for treating your knee pain. Dr. Bennett explains them both in this video. Dr. Bennett is a Board Certified Orthopedic Surgeon and a Knee Specialist. He’s also a Fellowship-Trained Sports Medicine Specialist. If you’d like an appointment with Dr. Bennett, please call our Sugar Land office at 281-633-8600 or our Houston office at 713-234-6346.
– Hi, my name is Dr. J. Michael Bennett, and I’m with the Fondren Orthopedic Group. I am a Sports Medicine Fellowship-Trained surgeon, specializing in shoulders, elbows, and knees.
Today we’re going to go over a brief overview of a couple of new techniques that are out there, regarding cartilage regeneration and cartilage healing. There are two different types of procedures now that you may see hear about, and I just wanted to go over them briefly.
One of them is called BioCartilage. This is made by Arthrex. The idea is to stimulate new cartilage formation through using small microfracture holes in addition to using cadaver cartilage cells. This helps create an overlay of new cartilage-like healing over the defect.
So if you look at a knee. Basically, you got a defect of cartilage here, which is exposed bone. And there’s certain patients that may be candidates for this. You can’t do this in patients that have diffused arthritis throughout the whole joint. It just doesn’t work. You’ve got to have small, isolated lesions in certain areas of the bone for you to be a candidate for the BioCartilage repair. You also cannot have arthritis on both sides of the knee. It has to be only on one side.
So what we do is go in arthroscopically and create little drill holes, in that exposed bone. After we remove the calcified layer, we expose the underlying subchondral bone there once we create the drill holes.
Sometimes, you can do this arthroscopically or you can do it through a mini-open approach. We go in and inject a very pasty configuration of cartilage donor graft, which is from a cadaver. This is mixed with bone marrow aspirate, meaning that we take bone marrow from up here in your tibia. We’ve got to suck out about 60 cubic centimeters of bone marrow and spin it down, to get bone marrow aspirate concentrate. That’s stem cells and bone marrow, mixed with this cartilage paste, to make this cartilage cadaver graft.
Then we lay it into that defect. So now you’ve got cartilage cells mixed with stem cells. The little drill holes are actually little tunnels where more bone marrow is coming out. Then we put a glue type of surface, it’s called Fibrin Glue, on top of that. That creates a nice surface, almost like you’re filling a pothole.
The great thing about BioCartilage is that you are creating a cartilage-like surface; however, you’re not getting a quicker recovery. You’re going to have to be protected, weight bearing, for a period of time. Generally I want my patients to have six weeks of non-weight bearing on that side, going to partial weight bearing, then full weight bearing. So you’re still looking at about a six month recovery.
This is not like a menisectomy, or just an outpatient knee scope. You still have a longer recovery with this. Because of the fact that you’re regenerating cells and getting cells to heal, you have to be protected for that period of time. That recovery time will allow this repair surface of your knee to solidify and actually become that cartilage like material.
Another option is something called DeNovo knee repair, which is similar. You have a large lesion here. You go in there arthroscopically, once again, you clean the lesion. And again, it has to be an isolated lesion on one side of the condyle, or the opposite condyle but not on both sides. And not throughout the whole joint.
We remove the calcified layer and expose the bone. We don’t drill the holes, like in BioCartilage knee repair. That was called a microfracture. With the DeNovo technique, you leave that subcondyle plate alone.
Then you take the graft, which is live, juvenile condyle cells. These are very, very immature chondrocytes, or cartilage cells, and they come in a little pack. They’re like little cubes, or little blocks. Then we lay them in the defect, and we spread them out all over the defect and we put the glue base on top of it again.
Again, it’s the same type of post-operative protocol. You’ve got to give it time to heal. You’ve got to give it time for these cells to incorporate and actually grow across the defect.
These are both very promising options. Oftentimes, it’s surgeon choice on what they prefer to use, whether it’s the DeNovo knee repair or the BioCartilage knee repair.
There are also some other videos that I did, out there, regarding other cartilage options. Such as the Osteochondral Allograft and Autograft option. So I encourage you, if you want to look at those videos for more information regarding those techniques, feel free to.
However, the BioCartilage and DeNovo techniques are two newer techniques that your surgeon may discuss with you. If you have any further questions, please come by the office. I thank you very much for watching.
Please call our Sugar Land office at 281-633-8600 or our Houston Galleria office at 713-234-6346. You can also click the Book an Appointment button at the top of the page to book your appointment online.
Dr. Bennett demonstrates an orthopedic knee examination in this video.
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