In 2019, however, he slipped and fell while frolicking with his young nephew in a natural waterfall during a Memorial Day outing at Georgia’s Kennesaw Mountain National Battlefield Park. “I didn’t think too much of it at the time,” says Oates, who lives in Raleigh, N.C., where he manages a moving-and-storage company. “My right knee hurt, but I ran through the pain. But my knee would swell, and it was impacting my stride.”
In January, he finally had an MRI, which showed he had torn his meniscus, a common sports injury to the cartilage that cushions the area between the shinbone and thighbone. But there was more. The scan also revealed an area under the kneecap where the cartilage had worn away, which often portends full-blown osteoarthritis — and possible knee replacement — years later. Unlike bone, which has the ability to heal, cartilage cannot restore itself once injured.
Until recently, Oates had few options, one of them to give up running entirely with the hope that his knee would not further deteriorate. He couldn’t live with that. “Running is my Zen time,” he says. “I couldn’t take a ‘you can’t run again.’ ”
Today, however, he says he hopes to benefit from a relatively new and innovative technique that regenerates cartilage from a sample of cells taken from his knee and grown in a lab, where they are embedded on a collagen membrane. The surgeon then implants the membrane back into the knee, where new cartilage tissue forms over time.
“It’s the first procedure that uses a patient’s own knee cartilage cells to try to regrow cartilage that has been lost or damaged,” says Seth Sherman, associate professor of orthopedic surgery at Stanford University Medical Center and chair of the Sports Medicine/Arthroscopy Committee for the American Academy of Orthopaedic Surgeons.
Sherman points out that the approach, approved by the Food and Drug Administration in 2016, has been in use for years in other countries with “robust evidence” to support its efficacy. “That’s why I like to use it,” Sherman says. “It’s a huge deal.”
It’s unclear how many of these cartilage-restoring operations have been performed in the United States since its introduction here, but experts say its use is rapidly growing.
“There are over a thousand of these procedures performed yearly in the United States,” says Joseph Barker, the Raleigh orthopedic surgeon who operated on Oates. “This new technology is certainly increasing in popularity as more surgeons become aware of it and are trained in performing the procedure. The number of cases has been steadily increasing by about 25 percent a year since 2017.”
The procedure is among the latest examples of regenerative medicine, a budding field that relies on the body’s natural properties to promote healing and restore function.
“Regenerative medicine and orthopedic surgery are starting to work together,” says John Ferrell, a D.C.-area sports medicine physician who specializes in regenerative treatments. “Even though its current application is still limited, I see it ushering in a new era