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Cartilage damage knee

Knee cartilage damage: cure limited, but sometimes possible

If there is a rubbing or even painful sensation in the joints, it may be due to cartilage damage in the knee. This usually arises from a defect in the cartilage structure, which occurs after an accident, but can also develop as wear and tear due to the natural wear and tear of the cartilage tissue. Since cartilage has only limited ability to regenerate, which also decreases with age, cartilage damage and its consequences are almost always dependent on proper treatment.

Once the cartilage tissue in a joint such as the knee has been damaged, it is important to avoid further damage to the joint, as otherwise not only severe pain will occur when the bones rub against each other, but the ability to move will also be restricted. Modern treatments aim at the best possible regeneration and preservation of cartilage substance, since in the last instance only a joint prosthesis can eliminate the symptoms.

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Orthopädie Zentrum München Ost - Knie - Erkrankungen

Table of Contents:

What is cartilage damage?
Causes: How does cartilage damage to the knee occur?

Cartilage damage in the knee due to wear
Traumatic cartilage damage in the knee

Symptoms of cartilage damage

Diagnostics and therapy of cartilage damage of the knee
Treatment of cartilage damage at the Orthopaedic Center Munich East (OZMO)

What is cartilage damage?

A complex structure of different types of tissue is required for joints to allow supple movement. The cartilage appears as a smooth tissue that lines the joint socket and covers the joint head. The cartilage layer is several millimeters thick. It serves as a kind of “shock absorber” between the bones, with the joint fluid acting as a lubricant to prevent friction. The cartilage is comparatively firm, but can still bind a lot of water due to the high content of collagen fibers, which enables elasticity and pressure equalization in the joint via the cartilage.

If the articular cartilage in the knee joint is permanently subjected to incorrect loads or becomes porous due to the natural breakdown of collagen production with increasing age, cracks, deformation and damage to the cartilage tissue can occur. The cartilage itself has no blood vessels and receives the necessary nutrients via the synovial fluid as well as via the periosteum. Because the supply of nutrients through the pathway is limited, cartilage has less regenerative capacity than other types of tissue. Stresses such as incorrect postures and the associated irregular pressure on the joints thus leave clear traces in the cartilage as wear.

In addition, accidents, for example during sports, can also influence the cartilage situation. Previous joint injuries are also often the origin of cartilage damage in the knee. Thus, insufficient rest of a malposition in the healing process can change the normal pressure on the knee joint and the cartilage can be degenerated by the additional load (usually incorrect load). Cartilage damage is distinguished primarily by the way it occurs.

Causes: How does cartilage damage to the knee occur?

Cartilage covers the boils on the joint surfaces like the tire on the rim. Cartilage damage in the knees is very common because as we age, the joints wear down and the cartilage increasingly wears away between the joints. Such cartilage damage is favored by a malposition of the joints, e.g. bow legs or knock knees. This results in the knee joints not being loaded evenly, causing cartilage damage in the overloaded areas. In addition to this degenerative cartilage damage, however, there is also cartilage damage caused by injuries or accidents. This results in the breaking out of entire pieces of cartilage or the formation of massive cracks in the joint surface, which can jam the joint accordingly.

Cartilage damage in the knee due to wear

The most common cartilage damage in the elderly from midlife onwards is caused by natural, age-related wear and tear or by chronic overloading and incorrect loading of the knee joint. Wear-related cartilage damage is referred to as degenerative cartilage damage and is considered mostly treatable if treated in early stages. Although not all damage can be cured in the case of cartilage damage, at least a progression of the knee joint situation is possible.

Traumatic cartilage damage in the knee

If cartilage damage occurs as a result of an accident, the medical profession refers to it as traumatic cartilage damage. This is caused by a very high force impact on the joint and the cartilage substance. In the long term, however, accidents can also cause cartilage damage due to wear and tear, for example if a slipped kneecap or a ligament injury (e.g. a cruciate ligament tear) results in prolonged incorrect loading or if the healing phase was not extensively and carefully attended to. Then there may be irregular loads on the joint, which wear away the bone substance and cause cartilage damage.

Symptoms of cartilage damage

In the case of cartilage damage due to wear and tear, affected individuals can remain symptom-free for a long period of time. Only when the knee cracks and crunches, sometimes movement is blocked or knee pain develops, do the typical symptoms of cartilage damage become apparent in more advanced stages. Since the cartilage is not traversed by nerve pathways, pain only becomes apparent when part of the cartilage is already no longer able to provide pressure compensation. The pain is often difficult to assign at first and occurs with exertion. In further courses, however, the pain may also occur during rest phases or as “start-up pain” (when starting a movement after a rest phase).

Traumatic cartilage damage often presents more quickly with pain and swelling as symptomatic. This is particularly the case when a piece of cartilage detaches or pieces of cartilage become trapped in the joint space.

Diagnosis and therapy of cartilage damage of the knee

Diagnosis of cartilage damage to the knee begins with a physical joint examination and, if necessary, some knee motion tests. Imaging techniques such as magnetic resonance imaging (MRI) provide information on joint structure. If there is any uncertainty, a joint endoscopy (arthroscopy) may also be considered.

If the damage is real cartilage damage, i.e. so-called “pothole defects”, reconstruction of the cartilage by means of cartilage transplantation is possible. In this procedure, a cartilage biopsy is taken from the joint in an initial outpatient keyhole operation and, if necessary, unstable portions that can no longer be fixed are removed. The cartilage cells are grown over several weeks and implanted in another keyhole outpatient surgery. In this way, cartilage defects can be made to heal completely.

This method cannot be used in the case of uniform degenerative abrasion of the cartilage. This is due to the lack of a “stable” casing, in which you can fill the cartilage, similar to the way you can not repair ruts on the road, unlike the pothole. However, there are also good conservative treatment options for degenerative cartilage damage that can no longer be operated on. Here, physiotherapy, with strengthening exercises for the thigh, stretching exercises, but also cycling is particularly effective, since good musculature relieves the cartilage. In addition, hyaluronic acid infiltrations can improve the nutrition of the cartilage and thus stabilize it. In cases where hyaluronic acid therapy does not have the desired effect, an autologous blood therapy can be used as an alternative.

Treatment of cartilage damage at the Orthopaedic Center Munich East (OZMO)

Do you feel a start-up pain in the knee joint more often or do you feel that the mobility has changed? Don’t be afraid to consider a comprehensive knee joint exam early on. Cartilage damage in the knee that is detected early can be treated well with modern medicine. We would be happy to welcome you to the Orthopedic Center Munich East with our team of dedicated orthopedic specialists to help you avoid serious pain and movement restrictions caused by cartilage damage through targeted treatments. Give us a call or send us a message so our knowledgeable practice team can schedule you for a knee joint exam.

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