Cartilage is the material makes up the surfaces of your joints. It is a amazingly specialized, incredibly smooth surface that lets bones glide effortlessly across one another, as well as withstand prolonged pressure without breaking down. Standing for several hours, for example, demonstrates the ability of your joint surface to hold up under pressure.

Cartilage is made up of mostly water (about 70%) and several compounds. These compounds are

Area of Damaged Cartilage

Area of Damaged Cartilage in the knee

porous, allowing the flow of fluid in and out, as well as fibrous to support your weight. Glucosamine and chondroitin, a common supplement, is a building block for cartilage.

The joint surface can become damaged with an injury when the joint moves in a way it is not designed to do, or with years of wear and tear, like a car tire. Once this damage has occurred, it is difficult to stop the process completely. When the cartilage was worn down to, or close to, the bone itself, people begin to experience pain with activities. Like the tire, the tread is gone.

Once the wear has become significant, your body tries to compensate by making the joint bigger, and hence ‘bone spurs’ will appear. Interesting to think that your body makes this cartilage and thereby does possess the ability to grow new cartilage, however seems to get it wrong and not put it in the weight bearing areas where it needs it.

Methods have been developed by orthopedists to stimulate the regrowth of cartilage. The most common procedure is called a micro fracture. With this approach, small passages are created into the bony surface allowing bone marrow to come out and create an area of healing. While not exactly the same as normal cartilage, this often does create a reasonable bearing surface in the joint and can eliminate pain.

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Another approach is to transplant cartilage from somewhere else in a joint, or from someone else, like a hair transplant! Grafts of cartilage and bone are harvested and moved into the defective area. This has been proven effective for small areas of cartilage injury, with less success in arthritic joints.

Newer approaches using stem cells and PRP are promising, without good studies in human patients to prove that they work. This is still considered investigational.

If you have questions about cartilage injury and ways to grow new cartilage, please feel free to contact me at Ask Dr. Hacker or through my office.

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