How Are Articular Cartilage Injuries Treated
Several treatments and therapies are available, including nonsurgical and surgical options. The choice of treatment depends on several factors, including age and overall health, physical activity level, desired post-treatment activities, and the type and severity of the articular cartilage injury.
Nonsurgical Treatment. Nonsurgical treatments are used to relieve symptoms and to prevent or slow further degeneration of cartilage. Nonsurgical treatments can improve quality of life by reducing pain and enhancing strength and mobility, but they cannot repair damaged articular cartilage. They are often used in the initial period following an injury, or when cartilage loss is extensive, as in the case of arthritis.
- Applying ice to the affected joint for 15 minutes every one or two hours to reduce swelling
- Elevating the joint to reduce swelling
- Taking over-the-counter anti-inflammatory medications, such as acetaminophen, to reduce pain and swelling
- Avoiding sports and activities that cause pain or involve heavy use of the affected joint
- Using an unloader brace to unload the cartilage injury
- Corticosteroid injections, to reduce inflammation and pain
- Viscosupplementation, a treatment in which a physician injects the affected joint with hyaluronic acid. This lubricates the affected joint, reducing friction between bones in the joint and decreasing pain.
How To Take Care Of Your Joints
Just as the tread on your tires wears away over time, the cartilage that cushions your joints can break down, too. It’s a condition called osteoarthritis. And without enough padding, your bones will hurt when they rub against each other.
Frayed cartilage can’t heal or grow back. “There’s no way to reverse the arthritis once it has started,” says Michaela M. Schneiderbauer, MD, an orthopedic surgeon at the University of Miami Miller School of Medicine. But you can ease the pain and protect the cartilage you still have. Use these tips to slow the damage.
1. Slim down if you’re overweight. It will help take stress off your knees and hips. Every pound you lose removes 4 pounds of pressure off your knee. That lessens wear and tear in the joint, Schneiderbauer says. “You may actually slow the progress of arthritis if you lose a significant amount of weight.”
What’s “significant”? “Every 10 pounds you lose will reduce pain by 20%,” says Charles Bush-Joseph, MD, of Rush University Medical Center.
2. Do aerobic exercise. Arthritis pain may make you reluctant to work out, but research shows that pain and stiffness get worse when you aren’t active enough. Regular exercise that gets your heart pumping will boost your blood flow, which keeps cartilage well nourished. And an extra benefit: it helps you reach a healthy weight.
“A strong muscle will prevent a limb from slapping down on the pavement and jarring the joint,” Bush-Joseph says.
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Orange County physician coordinator for Arthritis Introspective, a support group for those with arthritis, inflammatory diseases and autoimmune disorders.
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Treatments For Cartilage Damage
Self care measures are usually recommended as the first treatment for minor joint injuries.
For the first few days:
- protect the affected area from further injury by using a support, such as a knee brace
- rest the affected joint
- take ordinary painkillers, such as paracetamol or non-steroidal anti-inflammatory drugs such as ibuprofen
Get medical advice if your symptoms are severe or do not improve after a few days. You may need professional treatment, such as physiotherapy, or possibly surgery.
A number of surgical techniques can be used, including:
- encouraging the growth of new cartilage by drilling small holes in the nearby bone
- replacing the damaged cartilage with healthy cartilage taken from another part of the joint
- replacing the entire joint with an artificial one, such as a knee replacement or hip replacement this is usually only necessary in the most severe cases
Page last reviewed: 25 May 2019 Next review due: 25 May 2022
Diseases That Affect The Cartilage
Osteoarthritis results in the cartilage which covers the bone, , slowly thins and wears away. This results in a bone upon bone situation which can be extremely painful and reduces the ability to move. Osteoarthritis can often be the result of high stress to a joint due to a specific activity. Traditionally, osteoarthritis eventually is treated by surgery and the introduction of implants . Replacement joints are never as strong as natural ones.
A detached or ruptured knee can result when the knee is either detached, or the disc in between the two bones is ruptured causing a leakage of the lubricating synovial fluid and resulting in a bone on bone situation, which is extremely painful and adversely affects the ability to move.
Bursitis occurs when the pouches or sacs of synovial fluid, surrounding the knee, elbow or shoulder joint become inflamed. This is sometimes referred to as housemaids knee, and tennis elbow.
Torn cartilage occurs when the meniscus, , can also be damaged. The meniscus on the outside of the knee is the lateral meniscus, the meniscus on the inside of the knee is medial meniscus.
Costochondritis is the inflammation of cartilage in the ribs which can cause chest pain .
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Help For Arthritic Knees
Osteoarthritis is the most common cause of pain and disability in knees. In the knee joint, smooth articulate cartilage, called surface cartilage, covers the ends of the femur and tibia . Between the two bones sits a second type of cartilage, called menisci, which acts as a shock absorber. Joint fluid also lubricates the knee joint.
Osteoarthritis starts as the lack or loss of surface cartilage, progressively involving the surrounding bone, tissues and synovial fluid. In OA, your knee cartilage may thin in spots or disappear completely, resulting in areas of exposed bone.
X-rays, MRI and knee arthroscopy can help you and your doctor to determine the right treatment plan, which may include these noninvasive options.
Symptoms Of Torn Knee Cartilage
How do you know if youve sustained a cartilage tear?
You may experience acute symptoms like pain and buckling of the knee right after an injury, but not necessarily sometimes, cartilage damage can happen gradually over time, resulting in intermittent symptoms. Some people with meniscus tears have no pain and dont even realize they have an injury.
However, even if youre pain-free, you will likely note one or more of the following symptoms:
- pain or tenderness in the knee
- buckling or locking of the knee joint
- crunching or popping noises when walking
- dull pain under the kneecap when exercising
- difficulty bearing weight
- inability to bend or straighten the knee
- swelling or water on the knee, a buildup of fluid inside the knee joint
- tightness of the knee joint
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Restoring Cartilage In Your Joints
You may think that once your cartilage is gone, you cant get it back. That might have been true at one time, but with todays technology and our skilled surgeons, cartilage restoration is a great treatment option.
Usually, conservative avenues are the first line of treatment for your injury, unless its severe. This typically includes:
- Nonsteroidal anti-inflammatory drugs
- Steroid injections
If youve tried these without relief, its probably time to speak to one of our surgeons about cartilage restoration surgery.
This procedure is done by arthroscopy, meaning youll only need a few tiny incisions by your joint. Our surgeons will then insert small instruments into your joint to repair the damaged cartilage and repair the surrounding tissue if needed. This can be done by a method called microfracturing, which involves a sharp tool that our surgeons use to make small holes in the bone in your joint. This stimulates new blood supply, which in turn stimulates the growth of new cartilage.
This surgery is very effective in treating injuries within your knee, but can also be beneficial with cartilage loss in your shoulder and even your ankle. With new cartilage growth, youll likely experience a lot less pain in your joint and regain a lot of joint mobility.
There are other procedures that can also stimulate cartilage growth however, its up to you and your surgeon to determine what procedure is best for you and your injury.
Is It Possible To Rebuild Cartilage
In general, it is not possible to rebuild cartilage once it is gone. For those who are affected by conditions like osteoarthritis, the cartilage in joints will likely continue to wear away year after year, until there is none left. The only way to restore the joint at that time is to do a full replacement. Other possible treatments may include pain medications and supplements to ease stiffness and prevent further loss.
Although it is not possible to rebuild cartilage, some joints that are constantly painful may be replaced through surgery. Not all joints are eligible for this procedure, and the most common are the hips and knees. In most cases, an artificial joint is implanted into the body to replace the defective one. These new joints last upwards of 15 to 20 years, and pain is almost always alleviated entirely.
There are some indications that certain supplements and emerging treatments may help make it possible to rebuild cartilage, but there is not any evidence as of yet to back these theories up. Glucosamine, for example, has been rumored to rebuild cartilage in the joints of those who suffer from arthritis and other chronic conditions. Medical treatments are also under development, but they are not completed and have not been tested for effectiveness.
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The Process Of Producing New Cartilage
The formation of cartilage starts even before a person is born. It starts as a primitive, loose and undifferentiated connective tissue that subsequently undergoes differentiation in a process called chondrogenesis.
The cells involved in cartilage formation are called chondrocytes.
To simplify the growth process of cartilage, there are two mechanisms involved:
1. Interstitial growth
- The chondrocytes undergo cell division and increase in number
- The matrix of the cartilage is synthesized
- The cartilage expands from within
2. Appositional growth
- Premature chondrocytes called chondroblasts differentiate
- The matrix of the cartilage is synthesized
- The girth of the cartilage expands
So, how is understanding this growth process important to you?
Previously, orthopedic specialist hypothesized that articular cartilage cannot regenerate because it has no blood supply.
When you recheck the processes outlined above, you can see how easy it is to manipulate the growth of cartilage.
For instance, you can:
What Are The Ingredients Of Artificial Cartilage Gel
The main ingredients of this material include water-absorbing polymers. In the case of the artificial cartilage, the polymers are made of spaghetti-like strands, intertwined with another polymer that is less flexible and more basket-like. A third polymer that is made of cellulose fibers acts as a mesh holding the two other polymers.
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How Do I Know When Knee Cartilage Is Gone
In advanced cases, a patient with eroding cartilage will have to undergo surgery to replace the cartilage. A knee replacement will restore range of motion, reduce pain, and improve their quality of life. A transplanted cartilage is the best treatment option for osteoarthritis, but it is not a permanent solution. Until now, patients with eroding cartilage will need to endure painful and uncomfortable conditions.
If this is not possible, a patient will need a new procedure or medication. Medications and rest are not enough to prevent osteoarthritis from progressing further. In the meantime, the best treatment for osteoarthritis is to regrow healthy cartilage in the affected joint. While this is not an easy task, it could be a great help to countless patients suffering from this condition. By using a bioengineered scaffold, a doctor can implant fresh tissue into the knee.
A surgeon can repair osteoarthritis by removing damaged cartilage. In addition to removing discarded tissue, the procedure may damage healthy cartilage. The most common treatment for osteoarthritis is to replace the joint with a new one. The procedure is known to be quite effective and may be the best option for people with this condition. While it is still a long way from being able to regrow healthy cartilage in the knee, it is possible to use regenerative medicines.
What Can Cause Cartilage Loss In Knee Or No Cartilage In Knee
The articular cartilage in the knee, if damaged or injured causes discomfort in the joint. Losing cartilage in knee is a common occurrence in people suffering from arthritis. This results from wearing out of the cartilage due to overuse of the knee joint for many years. Sports persons or those with a history of knee injuries or trauma to the knee may too have cartilage deterioration, which usually get torn due to injuries.
Cartilage is an avascular structure, means it does not have blood supply of its own. Hence, once the cartilage is damaged, it does not heal on its own and may cause pain and discomfort in the joint.
Knee osteoarthritis is a condition in which the knee cartilage, due to repeated overuse of the knee joint, gets worn out causing cartilage loss in knee or leading to no cartilage in knee. The knee cartilage begins to break down resulting in open areas, which causes the bones of the thigh and leg to rub against each other. This cartilage loss in knee or no cartilage in knee results in joint pain, swelling and also limits the movement of the knee joint.
Inflammatory arthritis like rheumatoid arthritis, too causes an inflammatory reaction, which leads to pain and swelling of the knee joint, as the synovial lining gets irritated. Lost knee cartilage cannot be made up and hence such conditions often remain progressive due to continued use of the knee joint.
Articular knee cartilage damage is classified into grades based on the severity of loss of cartilage in knee.
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The Most Common Causes Of Cartilage Loss
- James Leiber, DO
Oftentimes, patients ask us what they can do to improve their joint cartilage and prevent arthritis. Cartilage is a connective tissue that acts as a cushion between the bones to protect our joints by absorbing shock.
The visual evidence of arthritis seen on imaging studies can be due to the decrease in quantity and quality of the cartilage, the decrease in joint space width, the formation of bone spurs, and degenerative changes in the bone underlying the cartilage. However, arthritis is not just a disease of wear and tear like you might think of a tire wearing away with more miles driven. There is a biologic component, that is, there are internal chemicals that promote or protect the wear and tear.
Foods To Increase Lubrication In The Knees
To help increase lubrication in the knees through nutrition, there are several foods to consider adding as a part of your healthy and well-balanced diet.
Some of these foods include salmon, trout, olive oil, nuts, avocados are all high in omega-3s. When you combine these foods with glucosamine sulfate and chondroitin, they can all work together to help increase lubrication while also decreasing inflammation. All of this will work wonders when it comes to pain relief as well.
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Can Your Cartilage Repair Itself
Our ability to heal and regenerate new tissues and cells is one of the amazing aspects of being a human. So, its natural to be curious if our cartilage can do the same and regenerate on its own. Learn more about your joint health as you discover more about the binding substance that is key in your overall mobility the cartilage.
Collagen Type 2 For Joint And Cartilage Support
A study in 2016 shows that collagen type 2 can help to relieve knee joint symptoms to prevent cartilage breakdown and decrease pain. The research also finds that collagen type 2 may help fight osteoarthritis. Collagen Type 2 makes up 55%-65% of the protein in cartilage and makes up to 92% of the collagen in articular cartilage.
Eating protein-rich foods on a regular basis such as chicken, beans, eggs, beef and various dairy products can be your natural collagen-boosting foods. The best collagen-boosting food we would like to recommend is the bone broth which is readily available in supermarkets or grocery stores or you can even make it yourself. Bone broth extracts collagen out of bones and leaving a tasty soup which is the perfect source of natural collagen type 2 supplement for your cartilage.
Collagen is also rich in amino acids that play a vital role in the rebuilding of knee cartilage and it may have anti-inflammatory effects. The quality of your cartilage will be strengthened over time by taking collagen-boosting foods along with the help of vitamin C and hyaluronic acid. Vitamin C and hyaluronic acid are essential components to help your body to absorb collagen.
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