Patient Education

About Cartilage Injuries

Articular cartilage is the smooth, white connective tissue that covers the ends of bones in joints, allowing them to glide smoothly over each other. It acts as a shock absorber, enabling joints to withstand weight-bearing and movement. Articular cartilage has no direct blood supply, making it difficult to heal once injured.

Traumatic injuries:

• Direct impact or trauma can cause articular cartilage damage, such as a cartilage shear injury where a piece of cartilage shears off the bone.

Degenerative injuries:

• Progressive wear and tear over time can lead to cartilage softening, fragmentation, and eventual loss (osteoarthritis).

Common Symptoms

• Pain and swelling in the affected joint
• Catching, locking, or grinding sensations when moving the joint
• Feeling of instability or “giving way” in the joint
• Stiffness and reduced range of motion

Cause & Anatomy

• Forceful impacts to the joint from sports injuries or falls
• Repetitive smaller impacts or overuse
• Twisting the joint while weight-bearing (e.g., twisting the knee with foot planted)
• Poor joint alignment due to congenital abnormalities or previous injuries

Diagnosis

• Patient history and physical examination
• Imaging tests like X-rays and MRI to visualize cartilage damage
• Arthroscopy may be performed for direct visualization

Prevention

Maintain Proper Physical Conditioning

• Being in good physical condition with adequate muscle strength, flexibility, and endurance can help reduce the risk of cartilage injuries, especially in athletes.
• Incorporate strength training, stretching, and cardiovascular exercises into your routine.

Warm Up and Cool Down Properly

• Perform warm-up exercises before activities to prepare the muscles, joints, and cartilage for the demands of exercise or sports.
• Cool down after activities to gradually reduce the workload on the joints and cartilage.

Use Proper Technique and Equipment

• Learn and practice proper techniques for your sport or activity to avoid excessive stress on the joints.
• Wear appropriate, well-fitting protective equipment like knee pads or braces if recommended for your activity.

Avoid Excessive Overuse

• Gradually increase the intensity, duration, and frequency of activities to allow the body to adapt.
• Vary activities to avoid repetitive stress on the same joints and cartilage.

Maintain a Healthy Weight

• Excess body weight increases the load and stress on weight-bearing joints like the knees, increasing the risk of cartilage damage over time.

Treat Injuries Promptly

• If a cartilage injury occurs, follow the RICE protocol (rest, ice, compression, elevation) and seek medical attention to prevent further damage.
• Allow adequate time for healing and follow recommended rehabilitation protocols before returning to activities.

Consider Preventive Exercises

• Neuromuscular training programs that focus on proper movement patterns, balance, and proprioception may help reduce the risk of cartilage injuries, especially in high-risk sports.

Treatment

Non-surgical:

• Rest, ice, compression, elevation (RICE)
• NSAIDs for pain and inflammation
• Physical therapy and activity modification

Surgical (for larger defects):

• Arthroscopic debridement to remove loose cartilage
• Marrow stimulation techniques like microfracture
• Osteochondral grafting (autograft or allograft)
• Autologous chondrocyte implantation (ACI)

The goals are to relieve symptoms, restore joint function, and prevent or delay the onset of osteoarthritis.

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