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Cartilage is one of the primary connective tissues that comprise the human body. It is composed mainly of water (65%). The remainder is a highly organized meshwork of substances collectively called a “matrix,” which are produced by “chondrocytes” (cartilage cells). There are different types of cartilage: Hyaline, Fibrous, and Elastic. The different types of cartilage have various properties that correspond to their roles within the body. As a result, there are a wide range of cartilage issues that one can experience due to normal wear as well as trauma.
Hyaline cartilage is the cartilage that lines the bony surfaces of our joints and provides a low-friction, smooth surface, allowing the bones to glide across each other during movement. Hyaline cartilage covers structures such as the ends of your bones at your knee and shoulder. Here, the cartilage helps to reduce forces and friction. This is the cartilage most often damaged due to sports and physical labor.
Cartilage, although a highly organized and complex structure, does not have a blood supply. As a result, injury can affect its overall function. Cartilage damage can occur through trauma such as a fall, or when playing sports. It can also occur in conjunction with injuries such as a tear of the ACL. Other cartilage injuries can result from alignment issues, rheumatologic conditions, and infection. Cartilage also commonly degenerates over time, eventually leading to osteoarthritis. Once damaged, it is challenging to repair or replace cartilage.
When cartilage is acutely damaged or wears slowly over time, there is an increase in stress to the underlying bone. This stress leads to joint pain, stiffness, loss of motion, and swelling. The joint then may also experience “mechanical symptoms.” Mechanical symptoms are when movement leads to a “catching” of the cartilage defect. This catching then can cause a sharp pain or inhibit motion. Sometimes pain can be localized to a particular location without any catching.
Cartilage problems are a diverse group of conditions. Various factors are important to consider when treating each situation. Factors that are important to consider include: Your symptoms, age, and weight, which joint is involved, the characteristics of the cartilage damage, any prior interventions, other associated injuries, and your overall health.
To evaluate the bones for fracture or arthritis, your physician will often obtain X-rays. An X-ray can sometimes tell your physician if there has been long-standing wear of your joint’s cartilage. If your X-ray does not show any significant change, an MRI may be helpful in evaluating your cartilage.
Conservative treatments will usually be recommended before cartilage surgery is considered. These non-surgical treatments include physical therapy, activity modification, bracing, NSAIDs, and injections (viscosupplementation, platelet-rich plasma).
Surgery will only be recommended directly if there is substantial damage from a traumatic injury, or if conservative treatments have been unsuccessful at managing pain and returning mobility. Your specific injury will dictate the available surgical options. Surgery may consist of either an “arthroscopic” or an “open” procedure, or even perhaps a combination of both. It is essential to discuss the nature of your cartilage injury and the treatment options available to you with your surgeon.
At Town Center Orthopaedics, the surgeons and physical therapists work together to ensure each patient achieves a tailored treatment plan specific to their injury. If you believe you may have injured your cartilage and would like to discuss treatment options regarding your specific condition, call us any time at (571) 346-2411, or book online today.
TCO provides patients with orthopedic problems the trusted resources and patient-centered advice they need to “Feel Better. Move Better. Be Better.”
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