Innovative Cartilage Transplant Preserves Knee Joint  

By Susan J. White

A history of knee problems plagued Stephanie Smith-Schellhorn, vestiges of her younger days as a competitive dancer and volleyball player. It was pain that she repeatedly shoved aside, until one morning, at the height of the pandemic, she could barely get out of bed and take a step.

“The next day I thought, ‘I can’t go on like this,’ and I headed to a NorthShore orthopaedic immediate care,” said the busy 37-year-old professional from Evanston.

By the time she arrived at the walk-in clinic, Smith-Schellhorn’s knee had ballooned to twice its size. The care team immediately scheduled her for magnetic resonance imaging (MRI) and an appointment with Orthopaedic & Spine Institute Surgeon Patrick Birmingham, MD.

Imaging tests revealed that a substantial amount of cartilage, the shock-absorbing tissue that cushions the knee joint, was missing. Dr. Birmingham likened it to a pothole in a road.

“If left alone, this could damage the other side of her knee and lead to severe osteoarthritis.” explained Dr. Birmingham, who holds an academic appointment at the University of Chicago Pritzker School of Medicine.

Regenerative Power

As an expert in regenerative medicine, Dr. Birmingham understands the power of using the body to repair itself. Stem cell therapies, cartilage transplants and platelet-rich plasma injections are a few of the promising answers for young adults like Smith-Schellhorn who want to preserve their joints.

“We talked about my quality of life and whether I wanted to consider a shorter, quick fix that might leave me needing a knee replacement in my early 40s, or if the cartilage transplant and longer recovery and rehabilitation would be a better option,” said Smith-Schellhorn, who chose the latter without hesitation.

Last December, after securing the right donor cartilage match, Dr. Birmingham skillfully removed the damaged section of bone and implanted healthy new cartilage into Smith-Schellhorn’s knee socket. The procedure went perfectly—the donor cartilage is now growing and adhering to bone—but her rehabilitation was demanding: six weeks of no weight-bearing activity and crutches for 10 weeks.

“Honestly, I wish I had done this sooner,” said Smith-Schellhorn. “I was prepared to shop around for a second opinion, but Dr. Birmingham and his physician assistant explained everything in great detail, and I felt 100% confident I was in good hands.”

Millennial Cautionary Tale

As millennials continue their active lifestyles and flock to high-intensity workouts, the conversation about joint pain needs to be broadened from a symptom of aging to what is available now that will repair and prevent osteoarthritis or an operation, said Dr. Birmingham, a nationally recognized sports medicine specialist and team physician for the Chicago Bears.

“Certainly, not everyone is the right candidate for regenerative medicine treatments, but healthy, younger adults like Stephanie typically have the best outcomes,” he said. “Millennials who experience joint pain for more than a week should be urged to get an evaluation. Patients should understand that sometimes joint pain can surface decades after an injury and that delaying treatment can cause irreversible harm.”

No longer needing to push pain aside, Smith-Schellhorn is back to hiking, riding bikes and even gracefully navigating airports in heels during business trips.

“I like walking, hiking, riding bikes and my Peloton, and I want to be able to keep up with the best of them,” said Smith-Schellhorn. “It was a long process, but I think of it as an investment in my health. I’m fit for the journey now.”