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.