Cartilage Damage Treatment
Joint cartilage has a limited ability to repair itself. Non-surgical or surgical treatment is planned according to the size and location of the damage and the patient's age.
Joint cartilage is the smooth, slippery tissue that covers the ends of the bones. It reduces friction during movement and spreads load. Because cartilage has no blood vessels, its ability to repair itself after injury is very limited. Untreated cartilage damage can grow over time and pave the way for arthritis.
What causes cartilage damage?
- Trauma: Sports injuries, falls or a dislocated kneecap can break off pieces of cartilage.
- Ligament and meniscus injuries: An unstable knee or a lost meniscus increases the load on the cartilage.
- Osteochondritis dissecans: A condition seen in young people, where the blood supply to the bone under the cartilage is disturbed.
- Overload and alignment problems: Bow legs or knock knees, excess weight and repeated strain.
- Age-related wear.
Symptoms
Pain that increases with weight bearing, swelling, catching or locking, and difficulty on stairs or when squatting are common. Some patients describe a feeling “like sand” in the knee.
Diagnosis
After examination, MRI is the most useful test for assessing the location, depth and size of cartilage damage. Standing X-rays show the joint space and leg alignment. The treatment plan considers the size of the damage, age, activity level and any associated problems together.
Treatment options
Non-surgical treatment
For small defects that cause no symptoms, and in older patients, exercises that strengthen the thigh muscles, weight control, activity changes and pain relief come first. In suitable patients, joint injections such as hyaluronic acid (viscosupplementation) or PRP can reduce symptoms.
Arthroscopic debridement
Loose cartilage fragments and irritating tissue are cleaned out arthroscopically. This is especially useful when there is catching or locking.
Microfracture
In small areas where cartilage is completely lost, small holes are made in the underlying bone so that cells from the bone marrow can cover the area with repair tissue.
Cartilage transplantation and tissue engineering methods
For larger defects, cylindrical plugs of the patient’s own healthy cartilage and bone can be moved to the damaged area (mosaicplasty), or cell-supported matrix techniques can be used. These treatments are usually preferred in young and active patients.
Correcting associated problems
If the leg is poorly aligned, a corrective bone operation (osteotomy) may be planned; if a ligament is deficient, ligament reconstruction may be done at the same time or in stages. Lasting cartilage treatment depends on removing whatever overloads the knee.
Recovery
Depending on the method, crutches and controlled weight bearing are needed for a while. Because new tissue takes months to mature, the rehabilitation programme must be followed patiently. Returning to sport usually takes several months.
How can cartilage be protected?
Losing excess weight, keeping the thigh muscles strong and choosing low-impact sports reduce the load on the cartilage.
Frequently asked questions
Does cartilage regenerate?
Joint cartilage has a very limited ability to regenerate. This is why preventing progression and planning treatment in time are important.
Does every knee with cartilage damage need surgery?
No. Many patients improve with exercise, weight control and injections. Surgery is considered for mechanical symptoms and suitable types of damage.
Can I run after cartilage treatment?
It depends on the size of the damage, the method used and how the new tissue matures. The timing of a return to running is decided together at follow-up visits.
The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.