Hannah Melick has always been an athlete. An outstanding softball player, Hannah was part of the women’s softball team for two years at the University of Minnesota. While she loved the sport, it came at a cost: severe pain in both knees.
“Life before surgery was honestly miserable. It hurt just to get out of bed,” Melick said. “I wasn't able to do any type of exercise except minimal swimming. It felt like I was a 23-year-old trapped in an 80-year-old’s body, which was not how I pictured my life would be as I graduated from college.”
Melick had worked with Orthopaedic Surgeon Jeffrey Macalena, MD, throughout her softball-playing days. Together, they pursued various treatments to help her deal with the pain without surgery.
“Hannah was a very high-level athlete, playing Division I softball. We got her through her years playing with physical therapy, injections and other measures, but by the conclusion of her playing time she was really struggling with pain in both knees,” Macalena said.
Melick’s pain was caused by a problem with her knees’ cartilage. Cartilage is the smooth, white tissue that covers the ends of bones where they come together to form joints. Healthy cartilage makes it easier to move by allowing the bones to glide over each other with very little friction. Cartilage begins to break down as a person ages, which can cause painful osteoarthritis. In older adults, total knee replacement surgery can fix persistent arthritis pain and swelling.
But a different approach is sometimes required for younger people experiencing the same problem.
Enter cartilage restoration.
The University of Minnesota Health Cartilage Restoration and Joint Preservation Program offered by orthopaedic specialists is an innovative approach to joint restoration that can extend the life of joints and repair any cartilage damage or defects. The program offers a range of treatment options, from cartilage transplantation to autologous chondrocyte implantation and realignment surgery—which is what Hannah eventually received. University of Minnesota Health care providers partner with each patient to find the right solution.
When Melick’s latest round of imaging showed that she had loss of cartilage under one of her kneecaps, it was time to consider surgery. After consulting with Macalena, she opted for the cartilage restoration procedure.
“I wanted to do basic things again, like play on an recreational softball team, go for a hike, play with my kids when I'm older or just get out of bed or walk up the stairs without pain,” Melick said.
Before Melick could undergo cartilage restoration, she needed to have a knee arthroscopy—a minimally invasive procedure that cleared some of the roughened cartilage out of her knee. Macalena performed this procedure. During the operation, he also removed a small piece of healthy “seed” cartilage from her leg.
Macalena sent those cartilage cells to a lab, where specialists grew them into new sections of cartilage ready for implantation. In July 2015, Melick underwent a cartilage restoration procedure. The newly grown cartilage was implanted back into her problem knee, where it would continue growing over the next few months.
Macalena also cut and repositioned one of the bones in Melick’s leg, changing her leg’s biomechanics to lighten the load on the knee while the cartilage cells regenerated.
“Dr. Macalena is the best doctor I have ever worked with,” Melick said. “He really understands his patient’s goals and what is realistic for the patient.”
Recovery after a cartilage restoration procedure occurs in stages over several months. Patients can expect to be on crutches with a brace for the first six weeks, and it typically takes four to five months to get back to running. Returning to competitive sports often requires eight to 12 months.
Knowing this, Melick opted to have the same procedure done on her other knee after recovering from the first procedure. In February 2016, she underwent the process a second time.
“My experience through University of Minnesota Health was nothing short of exceptional. Everyone there was friendly and informative. They told me what I needed to know for at-home care and called to check in on me the next day,” Melick said. “I was out and home the same day with no complications.”
Today, Hannah works as a patient care coordinator at a physical therapy and occupational therapy clinic in Spokane, Wash. She is also working toward a master’s degree in occupational therapy.
Now that she has recovered from both procedures, Melick’s life has changed for the better.“I jump out of bed every morning with zero pain in either knee. I have hiked 17 miles all around Sedona, Arizona in one day, ran a half marathon in under two hours, and am considering running a full marathon one day,” Melick said. “This freedom has changed my entire outlook on life, and I live a more positive life because of it. I can't thank Dr. Macalena enough.”