A new approach using a soft and squishy material called hydrogel may help rebuild healthy cartilage, according to findings reported this week in Science Translational Medicine.
An article published today in the San Jose Mercury News describes how the material works to mend damaged cartilage and keep joints moving. In the piece, Garry Gold, MD, professor of radiology at Stanford and a co-author of the new study, discusses the research and says the approach shows promise in becoming the standard for a simple, low-cost procedure. Ryder Diaz writes:
Unlike other parts of the body, cartilage does not receive a supply of blood, which carries the nutrients needed for healing.
One common method, called microfracture, drills tiny holes into the bone in the spot where the cartilage is missing. Blood and stem cells from the bone marrow spill into the damaged area. Surgeons hope these cells will grow into new, healthy cartilage.
But because there is nothing for the cells to hold onto, they often grow in a sloppy way, creating scar tissue. "The scar cartilage, it's less durable," [Jennifer Elisseeff, PhD, a professor at Johns Hopkins University and a co-author of the study] said.
That poor-quality cartilage can break down and disappear in two years, Gold said. Patients can experience the return of pain and the arrival of arthritis as more healthy cartilage disappears.
The new procedure tested by Gold, Elisseeff and colleagues added hydrogel to the microfracture technique.
Here, exposed bone is coated with a primer before holes are drilled. Then the gooey liquid hydrogel is poured in to fill in the missing cartilage, sticking to the primer. Light is used to set the gel, similar to the way a dentist uses light to solidify a filling in the cavity of a tooth.
The hydrogel creates a scaffold for the blood and stem cells from the bone marrow to cling to as they grow into healthy, new cartilage, Gold said. As new cartilage grows, the hydrogel dissolves.
After six months, the team found that patients treated with hydrogel had less pain and more healthy cartilage filled the pothole than the traditional approach.