In new research, doctors are trying to determine the effect of age on two popular surgical techniques for cartilage repair, microfracture and Autologous Chondrocyte Implantation.
Here is the summary of their findings:
Cartilage repair/regeneration proceduressuch as microfracture (a procedure to stimulate the growth of new articular cartilage by creating a new blood supply) and Autologous Chondrocyte Implantation -ACI- cartilage transplant from the patient or donor) usually results in satisfactory outcome in selected patients. HOWEVER:
The vast majority of patients with chronic symptoms and, in general, a more diseased joint, do not benefit from these surgical techniques
The reasons seem to point at how long a patient had symptoms and advancing patient age as the most relevant factors negatively affecting clinical outcome of cartilage repair/regeneration. Preliminary experience with Hyaluronic Acid, Platelet-Rich plasma (PRP), and Mesenchymal Stem Cells (MSC) has been positive but there is no strong evidence supporting the use of these products and this requires further assessment with high-quality, prospective clinical trials.
For older patients and for those with chronic symptoms, adjuvant therapies are needed in combination with microfracture and ACI.1
Making treatments work for the aging patient is one of the challenges facing doctors today.
Please refer to an earlier article where Platelet Rich Plasma Therapy enhanced healing in patients deemed too old to benefit from microfracture.
1. Scotti C, Gobbi A, Karnatzikos G Martin I, Shimomura K, Lane JG, Peretti GM, Nakamura N. Cartilage repair in the inflamed joint: considerations for biological augmentation towards tissue regeneration. Tissue Eng Part B Rev. 2015 Oct 15. [Epub ahead of print]