Articular Cartilage Injury
Articular cartilage is a white, smooth connective tissue that a flexible cushions covering the ends of bones in joints. The primary function of articular cartilage is to cushion the bones and enable them to easily glide over one another with very little friction which provides easy movement. A secondary function of articular cartilage is to help distribute load and weight placed across the surface of the joints. Articular cartilage is produced by chondrocytes which are cells that multiply and reproduce very slowly, which mean that articular cartilage injuries do not repair as well as other tissues in the body.
Articular cartilage injuries can be either traumatic or overuse injuries where the cartilage is damaged or breaks down, leading to pain and swelling. Normal wear and tear of everyday activates may cause articular cartilage damage. Articular cartilage injuries frequently occur in athletic individuals who exert a tremendous amount of pressure on their joints, causing the cartilage to wear or break away which can result in a painful catching sensation, swelling, and / or stiffness.
Individuals who have severely injured their articular cartilage typically experience the following symptoms:
- Severe pain and inflammation that increases with activity
- Reduced range of motion of the knee joint
- Sensation that the knee joints are catching or locking
- Tenderness around the knee joint
If these symptoms persist and affect an individual's day-to-day activities, visiting a physician is highly advised. Early detection and treatment of articular cartilage injury may help significantly reduce symptoms and prevent further damage to the knee joint.
Articular cartilage injuries can be diagnosed with a combination of patient history, physical examination, as well as imaging studies. The physician will examine the knee to assess the motion, stability, tenderness, swelling, and overall strength. Plain X-rays may be helpful in identifying a bone injury or early arthritis, but it will typically not identify an isolated articular cartilage injury. Therefore, the physician may order an MRI scan with or without a contrast dye injection, to determine the extent of damage and identify the proper plan of treatment.
The treatment approach for articular cartilage injury depends on severity of the condition. Appropriate non-operative treatments will relieve most symptoms and is generally the first method of treatment. Operative treatments are usually only be considered after trying more-conservative approaches.
Rest - It is advised to decrease or completely stop the activity that makes the pain worse. A great way to stay active while allowing the symptoms to subside is to switch to low-impact, cross-training activities such as biking or swimming.
Ice - Placing ice (with a barrier such as a towel) on the most painful areas of the knee for up to 30 minutes (less if the skin becomes numb) three to four times a day can greatly soothe the pain and keep the swelling down.
Medication - Over-the-counter anti-inflammatory medication such as ibuprofen and naproxen usually help reduce pain and swelling.
Surgery - Depending on the nature of the injury, the extent of the damage to the articular cartilage, and the affect it is having on an individual's day-to-day activities, articular cartilage damage can be repaired with minimally invasive surgery know as knee arthroscopy where small incisions are made around the joint. Surgical tools and the scope, which is essentially a small camera, will go into these incisions and the image will be sent to a video monitor allowing the physician to see inside the joint. A variety of surgical options can be considered and should be discussed with the physician.
Regardless of the treatment approach taken, patients go through a rehabilitation program which includes physical therapy exercises that are crucial to strengthen your leg muscle and knee joint. Each patient is unique, so the therapy program will vary based on his/her level of pain, extent of injury, and desired level of activity. Typically, most patients return to normal activities within three to four months, however, athletic activities and the return of strength can take up to a year; this is something to discuss with the physician as well as the physical therapist.
CALL 911 IMMEDIATELY IF YOU ARE HAVING A MEDICAL EMERGENCY!
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