Restoration of cartilage can be a successful alternative to knee replacement

Restoration of cartilage can be a successful alternative to knee replacement

The University Medical Center (UMC) in Utrecht, the Netherlands, has developed a new treatment to restore cartilage in the knee. This can result in postponing a knee replacement for years. For the 54-year-old Jan de Wit it is a godsend. “My knee is worn out to a degree that doing nothing was no longer an option,” he says at a radio interview with ‘Radio EenVandaag’. You can listen to the full radio interview in Dutch here.

There is a growing a demand for joint-preserving techniques, such as knee joint distraction (KJD), to treat knee osteoarthritis (OA). Because of the increased risk for revision surgery and the lower clinical efficacy in especially younger adults (younger than 65) patient group, it is important to avoid knee arthroplasty.

Jan had been having problems with his meniscus and cruciate ligaments for some time, causing his knee joint to wear out even faster. “The pain became so severe that I couldn’t sleep anymore and became less and less mobile. But the problem with a knee replacement is that it doesn’t last longer than 15 or 20 years. Then I would be back in business in my early 70s”.

With the new treatment method of the UMC Utrecht, patients can continue for years longer without knee replacement. An example of the application of this technique can be viewed here:

 

 

Cartilage can come back and regenerate
The method revolves around a metal frame that very slowly pulls the upper and lower legs of patients with osteoarthritis apart for 6 weeks. This gives the broken cartilage in the knee a chance to regenerate.

“It was always thought that cartilage does not come back once it is gone”, says professor of experimental rheumatology Floris Lafeber of the UMC Utrecht. “But we have been able to demonstrate that this is possible with this technique. With the so-called knee distraction you tackle the entire joint instead of a small part. People get recovery of their joint, the cartilage improves and they have considerably less pain.”

Prosthesis lasts 15 to 20 years
Rheumatologist Floris Lafeber and his colleague, orthopaedic surgeon Roel Custers, are optimistic about this alternative to knee replacement. “More and more prostheses are being placed at a young age, for example because more people are suffering from osteoarthritis due to obesity. On the other hand, many people also stay active longer, which causes them to wear out,” says rheumatologist Lafeber.

A prosthesis only lasts 15 to 20 years, and a second prosthesis is much more expensive and has less chance of success. This means that people can keep their own knee for as long as possible.

With Jan de Wit, the knee distractor can almost be removed. “I hope that my cartilage will have regenerated sufficiently and that I will be able to go through life without a knee replacement for many years to come.

For further reference, links and research:
https://link.springer.com/article/10.1007/s00142-020-00382-2

Link text: Medical Device Consulting 

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