Knee and joint pain is common among Americans. Just ask Augustana College Women’s Lacrosse Coach, Randall Haeflinger, 33, who has long suffered knee pain from injuries including a torn ACL as well as cartilage damage.
Randall is not alone. The American Academy of Orthopedic Surgeons (AAOS) estimates nearly 1 in 17 people visit doctor’s offices every year for knee pain due to injury or osteoarthritis.
There is good news. ORA Orthopedics is one of the first orthopedic practices in the region to offer joint preservation and cartilage restorative techniques that help preserve joints and rebuild cartilage, therefore extending the life of a patient’s natural joint.
Suffering from painful knees or other joints does not automatically mean total joint replacement surgery is inevitable. Recently, Randall underwent two procedures to repair his knee that may have otherwise required a knee replacement.
“I was playing with the team because we were down a few players, when I cut in and cut out, forcing my knee to collapse inward,” recalls Randall. “It was stretched to the point that I had to have surgery.” Sports Medicine Specialist, Dr. Suleman Hussain, ORA Orthopedics, discovered during surgery that Randall’s cartilage damage had not completely healed from a previous ACL injury years ago, leaving the knee weak and susceptible to further injury.
In addition to Randall’s injuries, an MRI showed that Randall suffered from OCD (Osteochondritis dissecans) a condition that causes lesions on the joints that look much like “potholes in the cartilage,” as Dr. Hussain describes. To stimulate healing of the smaller lesions, Dr. Hussain performed a minimally invasive procedure called a microfracture. “Through an arthroscope, I removed his loose and damaged portions of cartilage, then drilled several tiny holes to promote the growth of healthy ‘scar’ cartilage. The process acts as a scaffold for the cartilage to heal and integrate with his body.”
For Randall’s larger lesions, Dr. Hussain recommended that he replace the damaged cartilage in a procedure called OATS surgery. “OATS stands for Osteoarticular transplantation. Articular cartilage is the white tissue lining the end of bones where bones connect to form joints. Cartilage can be damaged due to age, injuries (such as Randall’s torn ACL), or OCD. In this procedure we take ‘plugs’ of either a patient’s healthy tissue or from a donor and graft it onto the damaged cartilage.”
In Randall’s case, he needed donor tissue and waited six months on a transplant list. “Since we are transplanting live cartilage cells, once the tissue is available and a good match, we have to move quickly to surgery,” says Dr. Hussain. “Much like an organ transplant, the tissue has to be fresh and alive. ORA works with several national registries to ensure our patients receive the best match to their own tissue. Instead of performing a joint replacement, we’re actually grafting viable cartilage back into the knee.
“The cartilage is a very important structure,” Dr. Hussain continued. “Unfortunately, it is also one of those structures that does not have a good potential to regenerate on its own after injury. Now, we are doing these procedures more often. People are more active. We would prefer to begin restorative therapy, especially instead of a joint replacement for younger athletes like Randall.”
ORA is the first orthopedic practice in our region that is able to coordinate donors and perform the cartilage transplantation. “It’s a complex multi-faceted effort, but we have a great team to shepherd our patients through the process.
“This is a big deal,” adds Dr. Hussain. “For young patients who suffer cartilage damage, we used to have fewer options for cartilage restoration or resurfacing. Now we can repair cartilage from injuries, trauma, cartilage loss, or conditions that cause lesions like OCD.”
Who are the best candidates for cartilage reconstruction procedures? Dr. Hussain says patients with cartilage injuries or old athletic injuries may respond well to treatment. “We look for patients who have sound and aligned ligaments. If they have isolated lesions, they need to be located in one small area of the knee. If the damage is diffused throughout the knee from age or widespread arthritis, these procedures may not be able to restore the cartilage effectively.”
For Randall, the procedures have put him back on the field and doing what he does best – coaching lacrosse. “My surgeries went fine,” says Randall. “My PT’s were thrilled that within a week in a half after surgery I could fully flex my knee. Six weeks later, I was able to walk again and then I shifted to an athletic brace. I’ll still wear the brace 24/7 for a few more months. Then I will be able to run, jump, and cut with more advanced practice.”
“It’s very important for Randall to return to coaching. Seeing him actually perform and demonstrate lacrosse techniques to players out there on the field is something that’s very rewarding for all of us at ORA,” says Dr. Hussain.
Watch ORA’s Dr. Suleman Hussain explain
this cutting edge surgery on WQAD-TV.