"When I would try running on it, I would get a sharp needle-like pain," said Kaspzyk.
That pain was felt with Kaspzyk's every step. He runs 80 miles a week.
"A lot of people have the same response. They'll say 'I can't imagine driving that long, let alone running it,'" said Kaspzyk.
But the wear and tear took its toll.
"I was told I had this big huge piece of missing cartilage," said Kaspzyk.
"Think of a pothole in your cartilage as a pothole in a road," Joseph Guettler, M.D., an orthopaedic surgeon at Beaumont Hospital in Royal Oak, Mich., explained to Ivanhoe. "If you keep driving over the pothole, or using your knee, the pothole will get bigger, bigger, bigger, bigger, and that means the pothole has progressed onto osteoarthritis."
Dr. Guettler used transplanted cartilage to repair Kaspzyk's knee. Cartilage cells are harvested from an area on the knee that's not hurt and sent to a lab where they are grown for six weeks.
"Believe it or not, they can grow something that's pretty darn close to real hyaline articular cartilage," said Dr. Guettler.
The cells are then injected back into the knee under a patch that covers the "pothole."
"We're taking cartilage cells, and instead of sending them off to a lab, we're simply mincing them at the time of the procedure," said Dr. Guettler. "They're sprinkled on a biological scaffold and implanted into the knee, all in one setting."
The surgery is quick, but full recovery can take a year. Kaspzyk has his running shoes back on and is planning his 40th marathon.
"I'll be running Boston next year, and whether I get under three hours or not, I'm still able to do it," said Kaspzyk.
And he'll do it without any pain.
The success rate with the cartilage transplant procedure at Beaumont Hospital is as high as 90 percent. Cartilage transplantation is only good for people who have not yet developed arthritis and could prevent them from getting it years later.
Web Extra Information:
When cartilage deteriorates in joints and causes bones to rub against each other, osteoarthritis often develops. When the condition takes place in the knee, bone and cartilage develop cracks and fissures that worsen over time, especially with high-impact activities that involve twisting, jumping and pivoting.
A recent study found even weekend warriors are prone to arthritis. Injuries that occurred in middle-aged people who showed no symptoms and had a healthy weight were more common and more severe in those who exercised more. Activities linked to a higher incidence or arthritis included sports, exercise, yard work and housework. Lower-impact exercise like swimming and cycling were found to have a protective effect against arthritis.
Surgery is a last resort for treatment of osteoarthritis. Non-surgical treatments include lifestyle modifications to avoid further impact to the affected area, exercise and medications like anti-inflammatories and corticosteroid injections. Surgeries to treat arthritis of the knee include cleaning debris and repairing tears through arthroscopy; osteotomy to cut the shinbone or thighbone to improve alignment of the knee; total replacement of the knee joint; or cartilage grafting for patients with limited cartilage loss.
A new surgical option still in research is cartilage transplantation. Joseph Guettler, M.D., an orthopaedic surgeon at Beaumont Hospital in Royal Oak, Mich., harvests cartilage cells from an uninjured area of a patient's knee and sends the cells to a lab where they are grown and multiplied for six weeks. The cells are then injected back into the knee under a patch that covers the depleted area. Full recovery can take a year, and Dr. Guettler says the transplantation procedure is for patients who have not yet developed arthritis, but are at risk. "We are filling their pothole and thus decreasing the chance of them progressing to degenerative arthritis as they age," Dr. Guettler explains.