Cartilage Damage

Cartilage tissue is a rigid type of tissue that covers joint surfaces, facilitates joint movement, and protects them. Cartilage, due to its unique structure, does not contain blood vessels, nerve endings, or a lymphatic system; therefore, it is nourished by joint fluid. Because of this structure, cartilage tissue is not prone to healing after injuries or self-generated wear and tear. Cartilage problems commonly seen in middle-aged and older individuals are often associated with a condition called osteoarthritis.

Treatments:

In young patients, cartilage problems often occur due to injuries following sports or other activities. Such problems typically affect a specific area and complete cartilage loss is rare. Patients may experience symptoms such as pain, limited range of motion, catching, locking, or a sense of instability. If left untreated, these problems can lead to further damage and persistent pain or early osteoarthritis in young and active individuals. Treatment options may include:

Load Management: Patients with cartilage problems may be advised to manage their loads. This may sometimes involve using crutches. Additionally, oral pain medications, cartilage-protective medications, special exercises, and physical therapy interventions, as well as intra-articular injections (e.g., hyaluronic acid, PRP, and stem cell applications), may be employed.

PRP (Platelet-Rich Plasma) Applications: PRP is a method used in many medical fields. In this method, the patient’s blood is drawn, and through a special process, a plasma rich in platelets, which contain growth factors that can stimulate the healing process, is obtained. PRP application in the knee joint aims to repair damaged cartilage tissue. However, the effect of this method on cartilage is still not definitively established, and results may vary.

Stem Cell Treatments: Stem cells are cells that can potentially differentiate into various cell types and can be obtained from bone marrow, muscle, fat tissue, or synovial fluid under specific conditions. However, their use in cartilage treatment is still limited and lacks sufficient medical evidence. In suitable patients, harvested stem cells are prepared in a laboratory setting and can be injected into the knee joint. This method is still in the research phase.

Surgical Treatments:

In cases where cartilage problems require surgery, surgical treatment options may be considered:

• Arthroscopic Cartilage Debridement: This is a closed method typically used for small and not completely lost cartilage defects. During an arthroscopic surgery, the joint is accessed, and the damaged cartilage area is cleaned with special instruments to achieve a smoother surface.
• Microfracture Method: The microfracture method is applied arthroscopically or in a closed manner. Damaged cartilage areas are cleaned, and holes are made in the underlying bone. This process can help stimulate the growth of blood and stem cells from the bone marrow to fill the damaged area.
• Mosaicplasty: This method involves taking healthy cartilage and bone tissue from areas without cartilage problems and transplanting them into the damaged area. It is used to repair localized cartilage defects.
• Cartilage Transplantation: This method involves taking healthy cartilage from the patient, culturing it in a laboratory, and then transplanting it into the damaged area. This procedure requires two surgeries.
• Surface Coating Implants: These implants are synthetic materials that cover a specific cartilage loss by filling it with metal. They may be preferred, especially in elderly patients.

Cartilage problems can affect the quality of life and functionality of many individuals. The limited self-repair ability of cartilage tissue makes treatment challenging. Treatment options can vary based on an individual’s lifestyle, symptoms, and the severity of the condition. The appropriate treatment option should be determined by a specialist based on the patient’s needs.