What is cartilage?

Cartilage is a firm yet extremely smooth connective tissue that covers the ends of bones to form joints. It is designed to absorb pressure when we stand, walk and run. This tissue can be damaged by an injury to a joint, or by chronic use like a tire of a car. Injuries occur when the joint is overloaded or twisted suddenly. When it’s injured, the normal smooth surface can crack or tear.

Unfortunately, when the joint surface is injured, the body does a poor job of healing it and making it smooth again. This can lead to areas of the joint surface that are worn down, and other areas that stay smooth, like a pothole on a smooth resurfaced street. When the cartilage is injured by chronic wear and tear, it also doesn’t re-form and wears thin, if not away completely.

What are the symptoms of a cartilage injury?

Cartilage Injury

Large torn flap of cartilage

Cartilage that has been injured can cause pain, clicking and catching. These symptoms often go away with rest, but then come back when you start moving again. The pain can be disabling. Another term for chronic cartilage wear is osteoarthrits – read more about it here.

Here, I want to focus on the sudden cartilage injury. Athletes that injure cartilage have similar symptoms to other knee injuries, with swelling, pain, limited range of motion, catching and clicking. Often times, these cartilage injuries are hard to see if not impossible on an Xray, and an MRI is needed to see where they are and how big they are.

How do you treat a cartilage injury?

The treatment always starts with simple icing, ibuprofen or other anti-inflammatory, rest, and gentle range of motion. The pain and swelling will typically subside in about 2-3 weeks. Most people will be able to go back to normal activities. If the pain and other symptoms persist, and it affects your daily activities, it may be worth looking into more treatment options.

Can I regrow my cartilage?

On its own, cartilage does not usually heal. The damaged tissue remains damaged. If there is injury to the bone as well, there is a chance there may be some healing. As result, many different treatments have been developed to try and regrow cartilage.

What is the surgical treatment for a cartilage injury?

Microfracture Cartilage Injury

Microfracture of a cartilage injury

The most common surgical treatment is called a microfracture. This simple outpatient arthroscopic procedure is done by creating passages from the joint surface to the bone marrow beneath, allowing this marrow to come up into the cartilage defect. The cells of this marrow are like stem cells and have the ability to become cartilage. Typically, the area heals with a cartilage-like scar that provides a smooth surface for more normal joint motion. While it is not true cartilage, most newer innovative treatments use this as the gold standard for comparison.

What is on the cutting edge of cartilage treatment?

New treatments to grow cartilage are amazingly promising. In one procedure, cartilage cells are taken from your knee, grown in a special way, and then replaced into the joint beneath a patch. Researchers are trying different ways to get the grown cartilage back into the joint. The results are promising.

Can you transplant cartilage?

YES you can. This is done by either taking cartilage from a less important area of the knee and moving it into the damaged area, or by taking cartilage from a donor and resurfacing the bad area. This has the advantage of using true cartilage to provide a new smooth surface. I’ve seen great results with this technique.

Dr. Scott Hacker is a Sports Medicine Orthopedic Surgeon in San Diego, CA, Team Surgeon to the US Olympic Team. He specializes in sports medicine and sports injuries, knee and shoulder surgery.

If you have questions about meniscus tears, or have a meniscus tear, please feel free to contact me at Ask Dr. Hacker or through my office.
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