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Cartilage Preservation and Restoration

The St. Luke’s cartilage preservation and restoration program is dedicated to the treatment of patients with symptomatic cartilage damage, including isolated cartilage defects, meniscal injuries and early arthritis. Our expert physicians will evaluate and recommend treatment options to match the physical demands of each patient's lifestyle. 

Our philosophy is to repair the cartilage damage by treating the whole patient and determining the underlying causes of damage, which can include malalignment, ligament instability and loss of meniscal function. We'll also educate patients on the safest and latest treatment options to help them to make the most informed decision regarding their cartilage damage. Conservative, or nonsurgical, management is usually attempted before more invasive, surgical options are considered. 

Our patients also have access to local and national cartilage repair and restoration research projects through partnerships with St. Luke’s Applied Research and Boise State University.

For more information on our cartilage preservation and restoration program, please call (208) 706-9040.

Non-Surgical Approaches to Cartilage Repair and Preservation

  • Lifestyle Changes

    Avoid aggravating activities, brace your joints for comfort, or begin physical therapy to improve strength and motion.

  • Therapeutic Joint Injections

    Used to help with pain and limited motion, corticosteroid or visco supplement injections can provide symptomatic relief and improved joint function.

  • Physical Therapy

    Our physical therapists can help you gain strength, increase range of motion, and restore mobility.

  • Platelet-Rich Plasma

    This therapy involves injecting your own platelet-rich plasma into an arthritic joint or injured tendon. 

Surgical Approaches to Cartilage Repair and Preservation 

  • Osteochondral Autograft Transplantation (OATS)

    This procedure repairs damaged cartilage by harvesting and transplanting healthy cartilage from a non-weight bearing area within your joint. 

  • Matrix-Associated Autologous Chondrocyte Implantation (MACI)

    Biopsies of your healthy cartilage are used to grow additional cartilage in the lab for implantation in your affected joint(s); this is the FDA's only approved cell therapy for cartilage regeneration.

  • Microfracture

    This technique, used with degenerative or traumatic cartilage loss, involves making small holes into the bone just below the cartilage defect to increase blood supply and promote healing to the area.

  • Osteochondral Allograft (OCA)

    This surgery uses donor bone and/or cartilage to repair cartilage defects; there is no need to take an immunosuppressant or anti-rejection medication, as reaction to the donor tissue is rare.

  • Patellofemoral Arthroplasty

    This procedure involves artificial joint resurfacing to treat patients with bone-on-bone osteoarthritis isolated to the patellofemoral compartment of your knee. 

  • Meniscal Transplantation

    A meniscal transplant can offer significant pain relief and improved function by replacing the damaged meniscus with donor tissue matched for size; typically appropriate for younger, active patients.

  • Hip Cartilage Repair

    Surgical approach depends on the size and severity of the defect: chondroplasty removes unstable cartilage, while microfracture helps restore the joint with scar tissue that behaves like cartilage. 

  • Foot and Ankle Cartilage Repair

    If surgery is indicated, commonly used surgical techniques include microfracture or drilling of the lesion, grafting cartilage and bone, or fixation of fragments with the help of screws. 

What to Expect

Your Treatment Plan and Recovery

First, your surgeon will obtain x-rays to evaluate your joint and determine whether or not you're a candidate for cartilage restoration surgery. Advanced imaging, such as an MRI, is usually necessary to assess cartilage defects and develop a treatment plan.

If your treatment plan involves surgery, you should know that most cartilage restoration surgeries are outpatient procedures, which means you'll go home after your procedure rather than stay in the hospital overnight. The majority of patients will begin slowly bending and straightening the joint soon after surgery to promote healing and improve motion. 

Physical therapy typically begins a couple of weeks after surgery. You may be asked to wear a brace for the first 4-6 weeks after surgery; full recovery takes approximately 6-8 months for high-intensity sports or activities.

Providers

  • Orthopedic Surgery

    Biography

    James T. Beckmann, MD, MS, AAOS, ABOS is fellowship trained in orthopedic sports medicine surgery specializing in arthroscopy of the hip, knee, and shoulder in both adults and pediatric patients. He currently serves as the medical director for the St. Luke’s athletic training residency program and as an orthopedic team physician for the Idaho Steelheads, Boise Hawks, US Soccer Federation, and Ridgevue Warhawks.

    Dr. Beckmann’s primary surgical specialties include: complex knee ligamentous reconstruction including ACL, patellar dislocation, meniscal tears, and cartilage restoration procedures; hip arthroscopy for structural disorders in athletes including labral repair; and shoulder disorders of the rotator cuff, labrum, and biceps tendon. In addition, he has expertise in tendon repairs of the hamstrings, biceps, and Achilles tendons. 

    Dr. Beckmann completed his specialty training at Stanford University, serving as an orthopedic team physician for their football, basketball, and volleyball teams. In 2018, he was selected as one of two physicians worldwide to complete a travelling fellowship in hip arthroscopy through the International Society for Hip Arthroscopy (ISHA). As a travelling fellow, he worked with leaders in the field of hip arthroscopy learning state-of-the-art techniques in hip arthroscopy including Drs. Marc Philippon and Thomas Byrd. He has published over 20 peer-reviewed journal articles and written seven chapters in prominent orthopedic textbooks.  

    Dr. Beckmann earned his bachelor’s degree at Duke University. He completed medical school at the Cleveland Clinic, where he also pursued a master’s degree in clinical trials.  He pursued his orthopedic surgery residency training at the University of Utah where he served as chief resident. 

    Availability

    Accepting new patients
  • Orthopedic Surgery

    Biography

    Tracye J. Lawyer, MD, PhD, FAAOS, ABOS is board certified and fellowship trained in orthopedic sports medicine and serves as the medical director for St. Luke's cartilage preservation and restoration program. She specializes in arthroscopic and open surgery of the shoulder, elbow, and knee. In addition to her medical degree, she also earned a PhD focusing on cartilage regeneration. Her special interests include pediatric and adult cartilage repair and restoration of the knee, shoulder and elbow, ACL reconstruction, meniscus repairs, meniscal allograft transplantation, multi-ligament knee reconstruction, patellar instability, total and reverse shoulder arthroplasty, rotator cuff repair, biceps tendon repairs, shoulder instability surgery and ligament reconstruction of the elbow. 

    Dr. Lawyer received her medical degree from The Ohio State University and her orthopedic residency training at the University of Mississippi Medical Center. She completed a sports medicine fellowship at the University of Pittsburgh where she worked with leaders and innovators in sports medicine, Dr. Freddie Fu and Dr. James Bradley. During her fellowship, she worked with the Pittsburgh Steelers and Pittsburgh Penguins. She has authored multiple peer reviewed research articles and has presented her work at national meetings. Dr. Lawyer is the team physician for the Rocky Mountain High School Grizzlies and Boise Hawks.

    Dr. Lawyer earned her bachelor's degree at Stanford University, where she was a two-sport athlete. She earned PAC-10 Player of the Year in soccer and was an NCAA track champion in the heptathlon. After college, she competed in the U.S. Olympic Trials in track and field, gaining valuable experience among the best athletes in the world. She later received the honor of induction into the Stanford Hall of Fame.

    Availability

    Accepting new patients
  • Orthopedic Surgery

    Biography

    Kaitlin C. Neary, MD is an orthopedic surgeon specializing in disorders of the foot and ankle. During her fellowship, she participated in the care of collegiate and professional athletes, and has experience in transplantation techniques for cartilage disorders and sports-related foot and ankle injuries. Dr. Neary has also published several research articles and book chapters on foot and ankle issues.

    Dr. Neary is an athlete herself, having played soccer in college and then in the U.S. Women's League. She is now a competitive cyclist, racing in road, mountain, and cyclocross disciplines. She understands the debilitating nature of orthopedic problems and enjoys working with patients to help them regain mobility and return to a desired level of activity.

    Availability

    Accepting new patients