On this website, you can find useful, updated information on specific cartilage-related conditions and possible treatments options, written by world-renowned experts in this field, helpful patient information to read and download, and other useful resources
The choice of procedures depends on the size and location of cartilage defect. Larger defects are typically treated with autologous chondrocyte transplantation, osteochondral allograft transplantation, or newer synthetic or natural scaffolds which may require open incisions. Smaller defects in specific locations may be treated with enhanced bone marrow stimulating techniques, autologous chondrocyte implantation (ACI), or osteochondral autograft transfer which may be completed through the arthroscope. There is also a chapter for conservative treatments options and rehabilitation after cartilage repair.
People of all ages can suffer from cartilage complications, whether due to ‘wear and tear’ or injury. While the former is much more common in middle-aged patients, and even more so in women, injuries to the joints, such as trauma or accidents during active sports, can affect any age group or gender. Careers requiring repetitive or intense motion can increase the risk of developing cartilage problems, but there are several other risk factors, including age, weight and genetic predisposition.
On this website, we focus only on articular cartilage repair treatments, which means the restoration of damaged hyaline cartilage in the joints. Cartilage repair and regeneration is a treatment for joints that have damaged cartilage but are otherwise healthy. Typically, these procedures are recommended for cartilage damage or deterioration caused by:
Injury or trauma, including sports injuries or repetitive use of the joint Congenital abnormalities – abnormalities a person is born with (for instance misalignment) – that affect normal joint structure Hormonal or idiopathic disorders that affect bone and joint development, such as osteochondritis dissecans (OCD). There are several types of new and modern procedures for cartilage repair and regeneration techniques that are designed to heal the cartilage by filling the cartilage defect (pothole) with repair tissue.
There are several types of bone and joint pain, each with many potential sources or etiologies. This site is not intended for people who suffers from rheumatoid arthritis (RA), gout, avascular necrosis (AVN), and cancer within bones, osteoporosis and other inflammatory or autoimmune diseases.
To the Mäxi Foundation:
This website project would not have been possible without the substantial support of the Swiss “Mäxi Foundation”. The ICRS would like to express a deep gratitude for this very generous contribution to the International Cartilage Repair Society and the respective patient community, making it possible to provide updated information about cartilage damage and cartilage repair technologies free of charge to all interested persons.
To the Authors & Contributors:
The following world-renowned experts in cartilage repair & cartilage research have contributed to the extensive content of this website: Stephen Abelow (USA), William Bugbee (USA), Susan Chubinskaya (USA), Brian Cole (USA), Stefano Della Villa (IT), Chris Erggelet (CH), Jack Farr (USA), Ralph Gambardella (USA), Michael Gerhardt (USA), Wayne Gersoff (USA), Alan Getgood (CA), Alberto Gobbi (IT), Laszlo Hangody (HU), Oliver Kessler (CH), Elizaveta Kon (IT), Jos Malda (NL), Bert Mandelbaum (USA), Tom Minas (USA), Kai Mithoefer (USA), Stefan Nehrer (AT), Lars Peterson (SE), Scott Gillogly (USA), Holly Silvers (USA), Jason Theodosakis (USA) and Kenneth Zaslav (USA)
To anyone else who contributed to this important project
ICRS Office Staff, Medical Writers, Committees, Illustrators and Web Developers, etc.
The information on the Website is not intended to treat, diagnose, cure or prevent any cartilage related issues. Always seek the advice of a physician or other qualified health care provider with any questions you have regarding your medical condition.
Dara Torres is arguably the fastest female swimmer in America. Since her first international swimming competition at age 14, Dara has proved that she is far from your average athlete. She is the first American swimmer to compete in five Olympic Games and has won a total of 12 Olympic medals in her career. In 2008 Dara captured the hearts and minds of people of all ages when she launched her comeback as a new mother at the age of 41 – eight years since her last Olympics when she retired from competitive swimming.
Dara discovered her talent and passion for swimming at a young age. She proved that she was far from your average athlete when she broke her first national record at age 12. She carried her success to the University of Florida where she earned the maximum 28 possible NCAA All-American swimming awards. At the Beijing Games in 2008, Dara became the oldest swimmer to compete in the Olympics. When she took three silver medals – including the infamous heartbreaking 50-meter freestyle race where she missed the Gold by 1/100th of a second – America loved her all the more for her astonishing achievement and her good-natured acceptance of the results..
“When I decided to make a comeback for the 2008 Olympics in Beijing at age 41, 6 years after competing in my 4th Olympics in 2000, I started experiencing knee pain in my left knee. I had had a couple meniscus tears (both lateral and medial) and just figured I needed a clean up. So in January of 2008 Dr Joe Chalal (in Florida) scoped my knee 6 months before our US Olympic trials. He said I was a grade 1-2 of cartilage loss and to be careful with my dryland training, which I was.
In the summer of 2008 I competed in my 5th Olympics in Beijing, having won 3 silver medals. When I got back to the US I decided to train for 1 more year so I could try and go to World Championships in Rome in the summer of 09. Halfway through that training (and about a year after the scope before Trials), I had another scope because of even more excruciating knee pain. Dr Chalal saw that my cartilage loss deteriorated to a grade 4. My knee was constantly filled with fluid. When I went to the World Championships in the summer of 09 I could barely get out of the pool because my knee hurt so bad, I couldn’t bend down to pick up my daughter and walking down stairs was a huge challenge and very painful. Dr Chalal recommended I see Dr. Tom Minas who specializes in Cartilage transplants.
As an athlete, the last thing you want is an injury to dictate the end of your career. An athlete always wants to finish their career on their own terms. When I met with Dr Minas in the fall of 2009, I had two options, but only one that was an option for me. They were knee replacement or cartilage transplant. Because I wasn’t sure I was finished with my swimming career I chose the cartilage transplant.
When Dr Minas scoped my knee to see the damage and retrieve the cartilage cells, he noticed my knee was much more damaged than the MRI showed. In addition to an osteotomy and an ACI, he also had to put plugs in my knee. Although there was some pain post op, I only had pain meds for a couple days post op and then switched to Tylenol. I hired a trainer who thinks outside the box but stayed within the limits Dr Minas prescribed. I was at 90 degrees ROM 4-5 days post op and immediately started using a compex machine to help prevent atrophy (in addition to the CPM and Game Ready). 2 weeks post op I was in the water walking laps in a pool (water chest high) to get my correct gate back when walking on land. Within 8 weeks my knee was feeling much better than it did pre surgery. Within a year I was back in the water training for the 2012 Olympics. At 45 years old I missed making the team by .09 but there’s no way I could have even considered training for a 6th Olympics if I had not gotten an ACI because my knee feels the best it’s felt in years. My knee wasn’t my enemy with not making that Olympic team, age was!
The best thing of all is that I have my quality of life back. I was able to get back to the activities I love most, skiing, snowboarding, waterskiing, spinning, boxing and the list can go on and on. But the most important thing for me was I was able to bend down and pick up my daughter again, something I couldn’t do before surgery. It’s not an easy surgery, and you have to have a positive frame of mind for the physical therapy, but I would never wish the pain I had in my knee on my worst enemy before I had the surgery. Now it’s as if I never had a knee problem in my life, the only giveaway is a scar on my kneecap.