The knee is covered with cartilage.
Cartilage is living material that produces glycosaminoglycans (GAG’s), which allow for lubrication as well as holding onto water within the cartilage.
Maintenance of cartilage is a dynamic process. Each time we cycle, ski the bumps or run, a number of cartilage cells perish. The cells are then replaced by circulating mesenchymal stem cells which differentiate into new cartilage cells. When the amount of damage exceeds repair, the cartilage starts to dry up and degenerate. When the balance is reversed so that repair exceeds the damage, the cartilage remains healthy and full of GAG’s. It is the balance that is key. Unfortunately, all the issues regarding regeneration and degeneration of cartilage have yet to be fully understood. What is known is that with age, the number of circulating repair cells (mesenchymal stem cells) decreases.
At Regenexx we attempt to restore a normal balance by injecting autologous bone-marrow-derived mesenchymal stem cells into the area of damaged cartilage. This is performed under x-ray guidance and a small needle. Regenexx is unique in that we utilize a patient’s own stem cells, and therefore avoid the risk of disease transmission or rejection. Unlike bone marrow aspirate concentrate therapies, we expand the number of mesenchymal stem cells so as to afford the patient the best outcome.
The MRI below outlines one of our recent knee successes. This is a patient who had undergone microfracture surgery on her knee due to significant loss of cartilage, without success. The top images are prior to the procedure, bottom images are 16 months after therapy. The red arrows identify breaks in the cartilage (white area in the gray cartilage). The yellow arrows point to the areas of previous cartilage damage which have now been repaired. Note the white areas which indicated cartilage damage have significantly resolved. Clinically, the patient is now pain free and was last seen somewhere in Vail.