Treatment of torn articular cartilage and menisci can include removing the flap. Some clinicians are too quick to say that if you take out a portion of the meniscus, that the patient will go on to develop articular cartilage damage or arthritis. What they neglect to mention is that the same thing will happen if nothing is done. The flap will continue to abrade the articular cartilage, causing damage. Also, in younger patients, when the tear is in a vascularized area, the meniscus will typically be repaired, not removed.

Note that the study mentioned in this article states that at 6 months, the patients who did not have the articular flap removed did better than those who did, but by one year later they were the same. This means that the patients who had the flap left behind got worse between 6 months and a year.

A partial menisectomy procedure in a degenerative meniscal tear with synovectomy and chondroplasty procedures works well, and the addition of platelet rich plasma (PRP) or bone marrow concentrate BMSC (stem cells) during the surgery greatly enhances the ability of cartilage to heal.

Interventionalists who claim that they can inject PRP or stem cells alone and alleviate all the afflictions of the knee joint, including any underlying mechanical and structural problems, are overstating their effectiveness.

Over the last 11 years I have found that adding PRP or stem cells to arthroscopic procedures greatly reduces healing time. In fact ,combined with certain types of chondroplasty or microfracture procedures, I have seen the healed cartilage one year later in MRI images.

There are also  A.C.I, M.A.C.I. and  A.M.A.C., some FDA-approved cell culturing techniques to regrow cartilage. In my experience, these give the best type of cartilage, but require a two step process. I have been able to get close to the same results by using stem cells from the bone marrow, concentrated at the time of surgery, activating the fibrinogen to fibrin with an activator, and creating a stem cell gel to apply to the defect.

Call us at, 941-953-5509 to schedule your stem cell consultation.