5
season does have an effect at least it
does for me.
The majority of injuries to the
knee are to the joint cartilage. Once
damaged, joint cartilage does not nor-
mally regenerate in the body. In addi-
tion to causing pain and restricted
mobility, chronic injuries to joint car-
tilage over time may lead to debilitat-
ing osteoarthritis. These manifesta-
tions can severely hinder a person's
normal activities and occupation.
Problems that cause these symptoms
are given many different names, but
no matter what your problem is
called, without a remedy, you still be-
gin and end each day in some pain.
The eco-
nomics as-
sociated
with knee
problems is
astronomi-
cal. This is
particularly
true for
those that
are left un-
treated. These injuries may lead to
osteoarthritis, leaving doctors few
options but to recommend knee re-
placement surgery. This type of surgi-
cal procedure is increasing, with ap-
proximately 200,000 total knee re-
placement operations performed an-
nually. At a cost of about $25,000
each, the procedure generates a whop-
ping $5 billion dollars in treatment
revenue. However, this isn't a very
appealing option for individuals un-
der the age of 50, as artificial joints
typically last only 10 to 15 years. For-
tunately, there are new alternatives
many of them available only in the
last several years - which can repair
worn knee cartilage and relieve pain.
Before we discuss the alternatives
available today, it's best to briefly
review the structure of the knee to
help explain the procedures that are
utilized by orthopedic surgeons. The
knee joint is the site where three
bones come together: the femur - or
thighbone, the tibia - or shinbone and
the patella - or kneecap. Because the
knee absorbs a tremendous amount of
stress and pressure the bones need to
be protected, thus a protective sub-
stance called articular cartilage, which
helps the knee move smoothly, covers
the ends of these bones. Another type
of cartilage, meniscal cartilage, acts
as a cushion between the bones and as
a stabilizing platform for the knee.
The knee has two crescent shaped
wedges of this cartilage, one on the
outside (lateral meniscus) and one on
the inside (medial meniscus), which
functions to protect the articular carti-
lage from damage.
Ligaments are also important for
the knee joint, as they serve to hold
the knee together and for stabiliza-
tion. Ligaments are bands of connec-
tive tissue that connect the bones to-
gether (in contrast to the tendons,
which connect the muscles to the
bones). The medial collateral liga-
ment (MCL), the lateral collateral
ligament (LCL), the anterior cruciate
ligament (ACL), and the posterior
cruciate ligament (PCL) connect the
femur and the tibia at the knee joint.
Most of the time when a person suf-
fers a ligament injury, it is to one of
these four major ligaments. There are
also other ligaments in the knee as
part of the knee capsule.
When damage to the knee occurs,
some people undergo arthroscopic
surgery. Arthroscopic surgery in-
volves placing a tiny camera (fiber
optics) into the knee through a small
incision to determine the extent of
injury. For minor injuries, an orthope-
dic surgeon uses arthroscopic surgery
to locate damaged tissue and trim
away areas of torn cartilage, which
can be the source of pain. These mini-
mally invasive procedures allow pa-
tients to recover quickly and usually
require at most an overnight hospital
stay.
Another method for treating
smaller defects allows an orthopedic
surgeon to remove a small plug of the
patient's own bone and cartilage from
one area of the knee and transfer it to
the damaged area of the knee. This is
BioTech Sage Report, January 2001
"biotechnol-
ogy will play
a significant
role in im-
proving pa-
tient quality
of life"
