Knee pain is one of the most common complaints from active men. If you don't have it now, the chance that you will someday experience knee pain – assuming you keep up the morning jogs or weekend tennis tournaments – is pretty high.
"Many men, especially as they get older, have lesions and tears in their articular cartilage, which pads the bones where they come together," says Dr. Riley Williams III, head team physician for the NBA's Brooklyn Nets and director of the Institute for Cartilage Repair at the Hospital for Special Surgery in New York City. "We've been taught that exercise leads to a better quality and longer life, so the current generation of middle-age men has lived by this advice." While this has led to many health benefits, the unfortunate downside has been a lot of wear and tear on the knees and other joints. "Damaged cartilage causes a bone-on-bone situation where there isn't enough cushioning," says Williams, "which leads to poor joint function and pain."
Like the pro ballers Williams tends to at Barclays Center, most guys aren't willing to let an aching knee sideline them from their favorite workouts. And sometimes that's okay. "Most men with knee cartilage injuries just wait, rest, wait, and see," Williams says. "Fortunately, oftentimes they can resume exercising after a brief period of rest."
But the bad news is cartilage damage can become more severe over time. "You might get to the point where sitting and waiting for the pain to improve doesn't work anymore," Williams says. That's because the body's natural ability to heal this tissue is pretty weak. "Articular cartilage has a very poor blood supply, which makes the delivery of essential nutrients to affected areas very difficult," he explains. "As a result, it's hard for lesions to heal on their own."
If you're popping Advil like Tic Tacs and ending most of your workouts with blazing knees, it might be time to see a cartilage surgeon. No operative procedure provides a perfect solution, but Williams, who's been researching cartilage repair since his med school days at Stanford in 1980s, says surgical options have come a long way in recent years. "To date, no clinician has been able to produce a repair tissue that is durable and strong like articular cartilage," he says. "However, research has shown that simply filling a defective cartilage hole with some other type of reparative tissue is good for knee function on the short and intermediate term."
One new procedure in particular has Williams and many of his colleagues completely psyched: DeNovo NT Natural Tissue Graft. According to a bunch of recent case studies presented at the American Orthopaedic Society for Sports Medicine's annual meeting in mid-July, patients receiving this treatment are seeing major improvements in pain, swelling, and their ability to work and play as they please – without having to undergo as much anguish as some other procedures cause.
Basically, DeNovo NT implants tiny chunks of cartilage from healthy donors under age 13 into a recipient's lesion, which is then sealed up with a protein-based glue. Over the next few months, cells from the donor cartilage migrate to surrounding tissues, multiply, and then new cartilage begins to grow. According to Williams, this procedure is relatively quick and not as painful compared to other traditional techniques like microfracture, and recovery time is fairly fast. Unfortunately, DeNovo NT is still new enough that many health insurance plans don't cover it – at least not up front – but it's also cheaper than some other methods.
"At the end of the day, it's still hard to create normal functioning articular cartilage following an injury," Williams says. "But now we have some solid options, including DeNovo NT. Make sure you find a surgeon who's skilled in every type of method to assure you're getting the procedure that gives you the best chance at healing and returning to the physical activities you love to do."