What to know before choosing joint care

Feeling better doesn't prove that cartilage grew back

Home care, medicine or office treatment may ease soreness without replacing worn cartilage. Surgery can also form patch tissue that differs from the original surface. Ask whether the suggested care aims to change soreness, movement or damaged tissue. Those aren't the same result.

A hot, swollen joint with fever needs prompt care. So does sudden weakness or being unable to stand and take steps after an injury.

The clinic owners benefit when a reader books

The owners who run the QC Kinetix clinics around Phoenix operate this site and benefit if a reader schedules with their Chandler office. That connection matters when you weigh what the clinic offers. Compare its explanation with the scan, the hands-on exam and advice from your regular doctor.

The ownership is stated plainly so the clinic's role isn't hidden.

A useful visit ends with clear answers

Regenerative treatments at QC Kinetix are office options without surgery that can use platelets collected from a patient's blood. PRP means platelet-rich plasma. Staff take blood, spin it to separate the platelets and place that portion into the sore joint through a needle. Concentrated PRP uses a higher platelet amount. At this office, medical providers examine the joint and perform the care.

You can ask what happens during treatment, what soreness may follow and which activity limits apply. It's also fair to ask when another type of care makes more sense.

Sources

1. Carbon-14 bomb-pulse dating of tibial plateau cartilage from 23 people born between 1935 and 1997 showed that virtually no replacement of the cartilage collagen matrix happens after skeletal maturity, and that neither osteoarthritis nor tissue damage changed that turnover rate. This is the measurement behind the statement that adult articular cartilage has almost no capacity for self-repair.

   Heinemeier KM, et al. — Radiocarbon dating reveals minimal collagen turnover in both healthy and osteoarthritic human cartilage.. Sci Transl Med, 2016. DOI: 10.1126/scitranslmed.aad8335.

2. The Cochrane review of surgical interventions for isolated cartilage defects of the knee in adults found only three randomised trials, all comparing mosaicplasty with microfracture, reporting 133 participants in total with a mean defect area of 2.8 cm2. It found NO randomised trials of allograft transplantation or drilling at all, judged every trial at high or unclear risk of bias, and rated the quality of evidence very low for every outcome.

   Gracitelli GC, et al. — Surgical interventions (microfracture, drilling, mosaicplasty, and allograft transplantation) for treating isolated cartilage defects of the knee in adults.. Cochrane Database Syst Rev, 2016. DOI: 10.1002/14651858.CD010675.pub2.

3. At two years in the randomised trial of ACI versus microfracture in 80 patients, both groups improved significantly, and the microfracture group's SF-36 physical component score improved significantly MORE than the ACI group's. Biopsies were obtained from 84% of patients and blinded histological evaluation showed no significant difference between the two repair tissues, with no association between histological quality and clinical outcome.

   Knutsen G, et al. — Autologous chondrocyte implantation compared with microfracture in the knee. A randomized trial.. J Bone Joint Surg Am, 2004. DOI: 10.2106/00004623-200403000-00001.