Chondrocyte advice

Advice 1

You will be considering chondrocyte cell implantation because you have a defect of your cartilage that lines one of your joints. It is obvious but you need to have significant trouble from this defect to consider this surgery as it is quite a major undertaking.

Many of these chondral defects heal on their own but if they persist and become symptomatic then generally surgical treatment is indicated. A simple debridement or microfracture through keyhole surgery is successful in most cases. If you have had this or similar previous surgery then you may want to consider Autologous Chondrocyte Implantation (ACI) as it uses the power of your own cells to recreate the missing cartilage on the surface of your joint. People who have had previous failed surgery are generally more of a mind to have ACI.

There is however increasing evidence that I think ACI as the initial treatment does give even better results.

 

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Advice 2

Although loss of cartilage is part of arthritis it usually takes 10 or 20 years before arthritis becomes a major problem. Once arthritis is severe and disabling then joint replacement is very good at relieving pain. You will only want to consider this once you have tried everything else, but when appropriate joint replacement in the knee and hip are now giving good results beyond 10 years, even with an active lifestyle.

The difficulties come when a joint replacement needs to be revised. For this reason they are best undertaken when you are older. Indeed, if you are over 50 then probably ACI is not appropriate for you. ACI does work extremely well in the older patient but does not work so well when there are several defects in one joint or when the underlying bone has become inflamed.

 

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Advice 3

Give up smoking and keep your weight down!

These are difficult to do especially in combination. You will however benefit from better cartilage healing and a lower rate of wear of your remaining cartilage. Use an exercise bike for half an hour twice a day with minimal resistance. This helps the cartilage that lines your joint.

Following ACI of the knee, hip or ankle it is very important for you to have this exercise. If you ask around neighbours or friends you will quickly find a spare exercise bike looking for a good home!