Meniscus Tears and The Importance of Preservation
The meniscus is a specialized, C-shaped piece of fibrocartilage that sits inside your knee joint. It acts as a vital shock absorber, distributing your body weight evenly across the knee and preventing the thigh bone (femur) from directly grinding against the shin bone (tibia).
Historically, a torn meniscus was simply removed (a procedure called a meniscectomy). However, modern research overwhelmingly proves that removing the meniscus massively increases the risk of developing early, severe osteoarthritis. Today, our absolute primary goal is Meniscus Preservation. Using advanced arthroscopic (keyhole) techniques, we use tiny suture anchors and specially designed stitches to pull the torn edges of the meniscus back together, allowing this crucial shock absorber to heal and protect your knee for decades to come.
Biological Augmentation: PRP and Fibrin Clots
The major challenge in repairing the meniscus is its blood supply. Only the outer edge (the "red-red zone") has a rich blood supply necessary for healing. The inner portion (the "white-white zone") is completely avascular, making natural healing nearly impossible without biological help.
To overcome this, we use advanced biological augmentations like Platelet-Rich Plasma (PRP) and exogenous Fibrin Clots. During surgery, we can draw a small amount of your own blood, spin it in a centrifuge to concentrate the healing growth factors, and inject this PRP directly into the tear. For complex or avascular tears, we create a gelatinous "Fibrin Clot" from your blood and surgically stitch it directly into the meniscus tear. This acts as a biological scaffold, delivering a massive dose of stem cells and growth factors straight to the avascular zone to supercharge the healing process.
Osteochondral Injuries: When Cartilage is Damaged
Unlike the meniscus (which is a removable shock pad), articular cartilage is the smooth, Teflon-like coating that is permanently attached to the ends of your bones. An Osteochondral Injury occurs when a piece of this smooth cartilage (and sometimes the bone underneath it) chips or peels off due to a sports injury or severe impact.
Imagine a pothole in a newly paved road. When the joint glides over this "pothole," it causes sharp pain, catching, swelling, and can rapidly expand, leading to widespread arthritis. Because articular cartilage does not have its own blood supply, it cannot heal itself. We must intervene surgically to fill the defect.
Marrow Stimulation (Microfracture)
For smaller cartilage "potholes," we utilize a technique called Microfracture Surgery. Using an arthroscope, we clean the edges of the damaged cartilage to create a stable boundary. Then, using a specialized tool, we create tiny holes (microfractures) into the hard bone at the base of the defect.
These tiny holes access the bone marrow, allowing blood and specialized bone marrow stem cells to flow up and fill the pothole. Over the next several weeks, this blood clot hardens and transforms into "fibrocartilage." While fibrocartilage is not exactly the same as your original articular cartilage, it provides an excellent, durable patch that relieves pain and protects the underlying bone.
Advanced Cartilage Regeneration: OATS and ACT
For medium to large cartilage defects, simple microfracture is not enough. We must bring in actual cartilage tissue to fill the void.
OATS (Osteochondral Autograft Transfer System): Also known as mosaicplasty, this procedure is used for medium-sized defects. We harvest tiny, cylindrical "plugs" of healthy bone and cartilage from a non-weight-bearing area of your own knee. We then transfer these plugs directly into the pothole, pressing them in flush with the surrounding surface. It acts exactly like a hair transplant, immediately restoring a smooth gliding surface with your body's own natural tissue.
Autologous Chondrocyte Transplantation (ACT / ACI): For the most massive cartilage defects, we use a two-stage, cutting-edge cellular therapy. In the first minor surgery, we harvest a tiny sample of your healthy cartilage cells (chondrocytes). These cells are sent to a specialized laboratory where they are multiplied into the millions over several weeks. In the second surgery, we implant these millions of lab-grown cells directly into your knee defect and seal them in place. Over time, these cells grow into pure, native hyaline cartilage, fully regenerating the damaged joint without the need for metal or plastic joint replacements.