Articular Cartilage Damage

Articular Cartilage Damage

Articular Cartilage Damage2023-05-30T10:06:08+00:00

Articular Cartilage; what is it?

Articular cartilage is a thin layer of connective tissue covering the bones’ ends where the “articulate”, meaning two joints or jointed sections meet and move. The articular cartilage allows the joint’s rigid structures to move without friction. Unfortunately, when this cartilage is damaged, it cannot heal on its own, so without treatment, you risk developing osteoarthritis and joint replacement surgery.

Articular cartilage damage; who gets it and why?

Articular cartilage damage is usually a result of injury due to falls, twists, and high impact, which is why this type of damage is commonly seen in athletes such as rugby players, and footballers.

Wear and tear are also an issue; again, this is seen in athletes or those over the age of 50. Heavy wear and tear could also be a result of lifestyle. For example, a career which involves heavy lifting or long daily periods of standing, walking, climbing, a builder, for instance.

Causes and risk factors of Articular cartilage damage include;

Overuse – Sporting professionals such as tennis players, for example, may also experience early onset OA.

Obesity – Extra weight and joint strain increase the risk of Articular cartilage damage.

Muscle weakness – Lack of core strength leads us to rely on our joints more, which can increase our chances of injury.

Lack of movement, inactivity or immobility – Long periods where the joint is not used can put you at a higher risk of injury.

Age – As we age, the risk of injury and developing OA increases.

Abnormalities within the joint – Factors such as impingement can increase the risk of injury and cause early-onset OA.

Environmental – work, sports and diet etc.

Articular cartilage damage; who gets it and why?

Articular cartilage damage is usually a result of injury due to falls, twists, and high impact, which is why this type of damage is commonly seen in athletes such as rugby players, and footballers.

Wear and tear are also an issue; again, this is seen in athletes or those over the age of 50. Heavy wear and tear could also be a result of lifestyle. For example, a career which involves heavy lifting or long daily periods of standing, walking, climbing, a builder, for instance.

Causes and risk factors of Articular cartilage damage include;

Overuse – Sporting professionals such as tennis players, for example, may also experience early onset OA.

Obesity – Extra weight and joint strain increase the risk of Articular cartilage damage.

Muscle weakness – Lack of core strength leads us to rely on our joints more, which can increase our chances of injury.

Lack of movement, inactivity or immobility – Long periods where the joint is not used can put you at a higher risk of injury.

Age – As we age, the risk of injury and developing OA increases.

Abnormalities within the joint – Factors such as impingement can increase the risk of injury and cause early-onset OA.

Environmental – work, sports and diet etc.

Signs and symptoms of Articular cartilage damage

Joint pain is instant on impact and can continue even when resting, and can often worsen over the first 48 hours, especially when trying to bear weight on the affected joint.

You may also notice –

  • Swelling and inflammation
  • Stiffness
  • Range limitation and joint locking
  • A clicking or grinding sensation
  • Weakness within the joint

Signs and symptoms of Articular cartilage damage

Joint pain is instant on impact and can continue even when resting, and can often worsen over the first 48 hours, especially when trying to bear weight on the affected joint.

You may also notice –

  • Swelling and inflammation
  • Stiffness
  • Range limitation and joint locking
  • A clicking or grinding sensation
  • Weakness within the joint

When should I seek help for Articular cartilage damage?

Unfortunately, the Articular cartilage damage will not repair itself, so it is fundamental that you seek medical guidance as soon as possible.

If left untreated, Articular cartilage damage can lead to further damage to the joint and early on set OA. Early measures can be implemented to prevent further damage to the joint, including walking aids, surgery and a recovery therapy program.

Articular cartilage damage surgery

There are multiple techniques and treatment options with variable indications and success rates. I will discuss the appropriate options after diagnosis, including using ultrasound-guided injections.

These include steroids, Hyaluronic Acid, Platelet Rich Plasma (PRP) and Autologous Protein Solution (APS).

Techniques include –

  • Radiofrequency coblation to smooth damaged cartilage
  • Marrow stimulation techniques (micro/nanofracture) allow stem cells to grow into fibrocartilage, filling the defect
  • Use of Matrix or Gel scaffolds to aid marrow stimulation
  • Augmentation is adding cells with growth potential to aid the above two
  • Keyhole surgery to reconstruct the articular cartilage

Again, the technique used will be based on the patient’s age, the site and size of the damage, the integrity of the meniscus and ACL, and the alignment of the limb.

When should I seek help for Articular cartilage damage?

Unfortunately, the Articular cartilage damage will not repair itself, so it is fundamental that you seek medical guidance as soon as possible.

If left untreated, Articular cartilage damage can lead to further damage to the joint and early on set OA. Early measures can be implemented to prevent further damage to the joint, including walking aids, surgery and a recovery therapy program.

Articular cartilage damage surgery

There are multiple techniques and treatment options with variable indications and success rates. I will discuss the appropriate options after diagnosis, including using ultrasound-guided injections.

These include steroids, Hyaluronic Acid, Platelet Rich Plasma (PRP) and Autologous Protein Solution (APS).

Techniques include –

  • Radiofrequency coblation to smooth damaged cartilage
  • Marrow stimulation techniques (micro/nanofracture) allow stem cells to grow into fibrocartilage, filling the defect
  • Use of Matrix or Gel scaffolds to aid marrow stimulation
  • Augmentation is adding cells with growth potential to aid the above two
  • Keyhole surgery to reconstruct the articular cartilage

Again, the technique used will be based on the patient’s age, the site and size of the damage, the integrity of the meniscus and ACL, and the alignment of the limb.

Articular Cartilage Damage Summary

  • The articular cartilage covers the ends of the bones and forms the smooth, frictionless surface that allows the joint to articulate
  • Damage can be due to a single blow to repetitive trauma and may result in anything from fissuring (splits) or delamination (peeling layers)
  • Damage can be from partial thickness to full thickness damage where it has gone down to the bone (technically an arthritic lesion)
  • Articular cartilage has no ability to heal by itself
  • There are several cartilage repair techniques which aim to grow new cartilage; however, it is not exactly articular cartilage but more fibrous cartilage (which is functional, but not as good)
  • Repair techniques work better in younger age groups and seldom work/are not attempted in patients above 55-60yrs of age

Frequently Asked Questions

I have compiled answers to several faqs for each procedure:

Articular Cartilage Surgery

When can I fly post op?2023-07-12T12:59:55+00:00

One can fly post op but one needs to be aware of their own mobility status and increased DVT risk within the first 6 weeks of any lower limb surgery. We recommend you discuss this with your surgeon.

When should I start physiotherapy?2023-01-21T11:19:26+00:00

Before your outpatient appointment at 2 weeks post-op.

How long should I have physiotherapy for?2023-01-21T09:40:25+00:00

9-12 months.

When can I drive?2023-01-21T10:24:20+00:00

3-4 weeks post op and when you can perform an emergency stop safely.

Is pain expected?2023-01-21T10:24:14+00:00

Mild to moderate for 2-3 weeks.

How long will I be off work for?2023-01-21T10:24:07+00:00

2-3 weeks.

Will I be able to walk normally?2023-01-21T10:20:55+00:00

Yes, but it will take 6 weeks.

How long do I need to wear stockings for?2023-01-21T10:21:54+00:00

2 weeks.

How long do I need to keep my dressing on for?2023-01-21T10:23:10+00:00

2 weeks.

Can I go home by myself?2023-01-21T10:23:28+00:00

Escorted.

When can I start exercising?2023-01-21T10:23:49+00:00

2 weeks post procedure and with the advice from your physiotherapist.

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