Articular cartilage damage


Articular cartilage damage

Description, Causes and Risk Factors:

Articular cartilage damage

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.

Grades:

    grade 0: (normal) healthy cartilage.

  • grade 1: the cartilage has a soft spot or blisters.

  • grade 2: minor tears visible in the cartilage.

  • grade 3: lesions have deep crevices (more than 50% of cartilage layer).

  • grade 4: the cartilage tear exposes the underlying (subchronal) bone.

Articular cartilage can be damaged by trauma, degenerative wear and tear or other specific joint diseases.

Causes of articular cartilage damage:-

    Trauma, eg fractures into the joint.

  • Degenerative, eg osteoarthritis.

  • Inflammatory, eg rheumatoid arthritis.

  • Others, eg Osteochondritis Dissecans.

Unfortunately, articular cartilage, once damaged, does not heal itself with new normal tissue, as bone does. The structure of articular cartilage is complex, and it is referred to as 'hyaline cartilage'. At best, areas of damage or cartilage loss may heal up with what is known as 'fibrocartilage', which is half scar tissue and half like cartilage. However, fibrocartilage does not have the same biological or mechanical properties as normal hyaline cartilage. At the extreme end of the spectrum, damaged cartilage may lead to patches of bare bone developing within a joint, with all the usual painful symptoms and signs of arthritis.

If left untreated, the joint, especially if it is a weight-bearing one, such as the knee, can eventually become so damaged that the person cannot walk. Apart from immobility, the patient may experienced progressively worsening pain.

All small articular cartilage defects can eventually progress to osteoarthritis, if given enough time.

Symptoms:

Articular cartilage damage can cause quite a wide variety of potential symptoms, depending on the severity of the damage. Symptoms may include:-

    Pain in the joint.

  • Swelling of the joint.

  • Catching or giving way.

  • Locking (where one is unable to fully straighten the joint).

If the area of cartilage damage is small, then a patient may feel a quite specific, localizable, intermittent sharp pain within the joint. If the cartilage damage is extensive and widespread, then the symptoms are more likely to be those of generalized arthritis.

Diagnosis:

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:

    Magnetic resonance imaging (MRI) - the device uses a magnetic field and radio waves to create detailed images of the body. It can often detect cartilage damage. However, in some cases, the damage cannot be seen on the MRI, even though it is present.

  • Arthroscopy - a tube-like instrument (arthroscope) is inserted into a joint to inspect and diagnose it. Repairs can also be carried out. This procedure can help determine the extent of cartilage damage.

Treatment:

Many procedures to restore articular cartilage are done arthroscopically. During arthroscopy, surgeon makes three small, puncture incisions around your joint using an arthroscope. Some procedures require more direct access to the affected area. Sometimes it is necessary to address other problems in the joint, such as meniscal or ligament tears, when cartilage surgery is done.

In general, recovery from an arthroscopic procedure is quicker and less painful than a traditional, open surgery. Your doctor will discuss the options with you to determine what kind of procedure is right for you.

The most common procedures for cartilage restoration are:

    Microfracture.

  • Mosaicplasty.

  • Drilling.

  • Abrasion Arthroplasty.

  • Autologous Chondrocyte Implantation (ACT).

  • Osteochondral Autograft Transplantation.

  • Osteochondral Allograft Transplantation.

NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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