OPDDr.L H Hiranandani Hospital, Powai
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Articular cartilage is the smooth, white tissue that covers the ends of bones where they come together to form joints. Healthy cartilage in our joints makes it easier to move. It allows the bones to glide over each other with very little friction.
This articular cartilage surface can be damaged by trauma such as a sports injury. Normal use, including running, won’t wear out the cartilage unless it’s been previously injured or if the meniscus cartilage has been removed. Bone malalignment or being overweight can also contribute to damage. The diseases of osteoarthritis and inflammatory arthritis can directly damage the cartilage surfaces as well.
Once damaged, articular cartilage will not heal on its own. Over time, the cartilage breaks down and the underlying bone reacts. As the bone stiffens and develops bone spurs, (osteophytes) the joints become inflamed and swollen, which damages the cartilage even more, leading to pain, swelling or loss of motion. This is traumatic osteoarthritis.
Knee osteoarthritis is the most common form of arthritis, affecting millions of people around the world. Untreated, it is usually a progressive degenerative disease in which the joint cartilage gradually wears away.
In severe cases a piece of cartilage can break off and the joint can become locked. This can lead to hemarthrosis (bleeding in the joint); the area may become blotchy and have a bruised appearance. Articular cartilage damage most commonly occurs in the knee, but the elbow, wrist, ankle, shoulder and hip joint can also be affected.
Although articular cartilage damage diagnosis may sometimes be extremely challenging, modern non-invasive tests make the job much easier than it used to be. Differentiating between cartilage damage in the knee and a sprain or ligament damage is not easy, because the symptoms overlap.
After carrying out a physical examination, the doctor may order the following diagnostic tests:
Non-surgical treatments, such as physiotherapy and non-steroidal anti-inflammatory drugs (NSAIDs), are usually recommended for minor to moderate cases of cartilage damage.
Surgery may be required in more serious cases. There are a number of surgical techniques available, such as encouraging the growth of new cartilage, or taking a piece of healthy cartilage from elsewhere in the joint and using it to replace damaged cartilage.Early identification and treatment of articular cartilage damage can have a significant effect on outcomes for patients.
Surgical options include: