Articular cartilage damage
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Cartilage structures and functions can be damaged. Such damage can result from a variety of causes, such as a bad fall or traumatic sport-accident, previous knee injuries or wear and tear over time. Immobilization for long periods can also result in cartilage damage.[citation needed]
Articular cartilage damage in the knee may be found on its own but it will more often be found in conjunction with injuries to ligaments and menisci. People with previous surgical interventions face more chances of articular cartilage damage due to altered mechanics of the joint. Articular cartilage damage may also be found in the shoulder causing pain, discomfort and limited movement.
Articular cartilage does not usually regenerate (the process of repair by formation of the same type of tissue) after injury or disease leading to loss of tissue and formation of a defect. This fact was first described by William Hunter in 1743.[1] Several surgical techniques have been developed in the effort to repair articular cartilage defects.
Carrie wears cartilage on her ears Echosmith cool kids - (Kenzie Nimmo cover)
Consequences
Articular cartilage has a very limited capacity for self repair. Small damage does not repair itself and can often get worse over time. As cartilage is aneural and avascular (lack of nerve and blood supply, respectively), shallow damage often does not trigger pain.
When the damage increases and the chondral defect reaches the subchondral bone, the blood supply in the bone starts a healing process in the defect. Scar tissue made up of a type of cartilage called fibrocartilage is then formed. Although fibrocartilage is able to fill in articular cartilage defects, its structure is significantly different from that of hyaline cartilage; it is much denser and it doesn't withstand the demands of everyday activities as much as hyaline cartilage. It is therefore at a higher risk of breaking down.[2]
Wang et al.(2006) found that small articular cartilage defects can progress to osteoarthritis over time if left untreated.[3] An articular cartilage defect that initially may be small still has the potential to have a physical and chemical "domino effect" on the surrounding "normal" articular cartilage.[2]
Treatment
Though articular cartilage damage is not life-threatening, it does strongly affect one's quality of life. Articular cartilage damage is often the cause of severe pain, knee swelling, substantial reduction in mobility and severe restrictions to one's activities. Over the last decades, however, research has focused on regenerating damaged joints.
These regenerative procedures are believed to delay osteoarthritis of injuries on the articular cartilage of the knee, by slowing down the degeneration of the joint compared to untreated damage.[2] According to Mithoefer et al. (2006), these articular cartilage repair procedures offer the best results when the intervention takes place in the early stages of the cartilage damage.[4]
References
- ^ Hunter W. On the structure and diseases of articulating cartilages. Trans R Soc Lond 1743;42B:514-21[full citation needed]
- ^ a b c Cite error: The named reference
cartilagehealth.comwas invoked but never defined (see the help page). - ^ Wang, Y.; Ding, C.; Wluka, A. E.; Davis, S.; Ebeling, P. R.; Jones, G.; Cicuttini, F. M. (2006). "Factors affecting progression of knee cartilage defects in normal subjects over 2 years". Rheumatology. 45 (1): 79–84. doi:10.1093/rheumatology/kei108. PMID 16188947.
- ^ Mithoefer, K.; Williams, R. J.; Warren, R. F.; Wickiewicz, T. L.; Marx, R. G. (2006). "High-Impact Athletics After Knee Articular Cartilage Repair: A Prospective Evaluation of the Microfracture Technique". American Journal of Sports Medicine. 34 (9): 1413–8. doi:10.1177/0363546506288240. PMID 16735588.
