Arthritis is caused by degeneration or damage to the cartilage surface of the bone. Cartilage is the tissue that cushions the bone and helps the joints glide smoothly. If the cartilage is damaged or wears out over time, this is referred to as arthritis. 

As the damage to the cartilage becomes more severe, people begin to feel pain in their knee, which can range from a dull ache to a sharp pain. This is also usually associated with swelling or the sensation of catching when bending the knee. Typically, this pain is worse with increasing activities such as prolonged walking, exercise or participating in sports.

Often, your doctor will diagnosis this problem by examining your knee, taking an x-ray, and possibly performing an MRI of the knee. The MRI may show evidence of damage to the cartilage. The damage may be localized in one area of the knee or may be more diffuse, affecting different parts of the knee joint.  

Treatments for mild cartilage damage involve avoiding painful activities, physical therapy, and anti-inflammatory medications such as ibuprofen. For more severe cases, treatments range from a steroid injection to surgery. For patients with localized arthritis, a surgical procedure known as knee arthroscopy can be performed. This is a minimally invasive procedure used to evaluate cartilage damage, which typically appears as an area where the cartilage has been damaged or worn away, leaving just the bone below. Sometimes, damage to the cartilage occurs in only one area of the knee. In this situation, a sample of the surrounding cartilage can be taken. This allows us to use a new technology for cartilage repair known as MACI (Matrix Associated Autologous Chondrocyte Implantation).

MACI technology uses the cartilage sample to isolate and grow (multiply) the patient’s own cartilage cells. The cartilage cells are then transferred to a special membrane that can be inserted into the area of damage. This is like using a patch to fill up the hole left behind by cartilage damage. However, the patch is made from the patient’s own cartilage cells. The transferred cartilage cells then grow, which creates healthy cartilage and reverses the original damage. This procedure has been shown to significantly reduce pain and may be an alternative to knee replacement for certain patients with arthritis. 

Thomas Sanders, MD completed his medical education at the University of Texas Medical School in San Antonio, TX. He completed his orthopaedic surgery residency and sports medicine fellowship at the Mayo Clinic in Rochester, MN. Dr. Sanders serves as the orthopaedic team physician for Webb City High School.