Cartilage Restoration Reduces Pain, Improves Function, Preserves Joints

By Anne Gallagher

Running on a treadmill for 45 minutes is something you might expect from an athlete. You certainly wouldn’t expect it from a woman who had difficulty walking. Yet, thanks to cartilage restoration, amazing things can happen.

Meet Cheryl Borowski, a 35-year-old resident of Eaton Township, Ohio, who used to walk with a limp and now tears up the treadmill. In high school, she played volleyball and was a member of the marching band. At one point, she played on six different softball teams. Yet, for most of her teen years and beyond, knee pain plagued her.

“Eleventh grade is when it started,” she says. “I couldn’t straighten my knee for two to three months at a time. In ‘87, I had arthroscopic surgery, and the relief lasted eight years. Then it got bad again and I had another surgery, which only lasted six months. At that point, the doctor who performed the surgery recommended that I see Dr. Williams.”

In addition to serving as director of the Cleveland Clinic Department of Orthopaedic Surgery at Euclid Hospital, James Williams, MD, heads up the hospital’s newly formed Cartilage Restoration Center. “The most rewarding thing about this work is seeing people get better so that their daily life is no longer negatively affected by the acute problems they had,” he says.

For Borowski, severe knee problems certainly did impact her daily life in drastic ways. “Any pressure to my knee brought tears to my eyes,” she says. “I couldn’t grocery shop. I couldn’t even pick up my pet cats, Tigger and Outlaw. I’d be walking and my knee would just give out. I was depressed.”

Borowski’s surgery was a two-step process. First, she had healthy cartilage removed or “harvested” from three tiny holes in her knee during an arthrosopic procedure. The cartilage was immediately flown to a cell culture laboratory in Cambridge, Mass., where it grew for two weeks and multiplied into millions of cells.

“The lab sends these millions of cells to us in a tiny vial that’s about half the size of a small Hershey kiss,” says Dr. Williams. “During surgery, we removed the damaged cartilage and implanted the new, healthy cartilage cells into the patient’s knee by sealing them beneath a patch. Without this surgery, Cheryl would have developed significant arthritis in her knees over time. The surgery should keep her knees in great shape for years to come.”

“I feel wonderful,” says Borowski. “Dr. Williams gave me my life back. It’s the simple things you take for granted that I really appreciate being able to do now.”

Following her surgery, Borowski took pain medications for a short while and started intense physical therapy three to four times a week, along with hydrotherapy at Cleveland Clinic facilities. “After three months, I felt like, ‘Yea! I can accomplish anything again!’”

Absorbing the Shock
Imagine a car without any shock absorbers. You’d feel every little bump on the road. That’s how it feels for people who have damaged or missing cartilage in their bodies. When a person’s cartilage breaks down, they develop arthritis – the most common form of which is osteoarthritis, a chronic condition affecting an estimated 40 to 60 million Americans. It is often called the “wear-and-tear” arthritis.

Cartilage is flexible connective tissue that cushions the ends of bones and enables the joints to move easily. When cartilage wears down, the bones can rub against one another, and this leads to stiffness, pain and loss of movement in the joint. Unfortunately, cartilage does not heal readily.

“If someone is missing cartilage, they’ll eventually develop arthritis,” says Dr. Williams. “Cases of arthritis in America are growing like crazy – especially among baby boomers who have been active their whole lives. At least 80% of the cases we see at Euclid are related to arthritis or damage to the cartilage.

“I have arthritis too,” he notes. “Plus, I’ve been very involved in sports all my life – as a competitor, spectator, parent and coach – and have had many of the injuries that my patients have. This has made me very sensitive and understanding of what my patients are going through.

“You come into medicine so that you can take care of people the way you’d want to be cared for,” Dr. Williams adds. “I approach every case as if the patient were my own son, mother or other relative.”

Apparently, his efforts are paying off. Borowski says, “I have my life back, and I feel wonderful. I highly recommend Euclid Hospital, the procedure and Dr. Williams.”

According to Dr. Williams, not everyone is a candidate for cartilage restoration. “But if they’re not, we’re able to give them other options here at the department of orthopaedics,” he says. “Healing people and improving their lives is what we focus on, what we excel at and what we’re passionate about.”