A Family Doctor's Tale - ARTICULAR CARTILAGE INJURY

DOC I HAVE ARTICULAR CARTILAGE INJURY

Articular Cartilage Injury is a common disorder of the knee caused by damage of the surface of the cartilage covering of the knee.

It can also occur from wear and tear through repeated friction of the cartilage resulting in chronic wear and tear or direcr trauma.

The carticular cartilage acts to allow frictionless movement of the bone against another and performs also as a shock absorber during weight bearing activities.

The causes of Articular Cartilage Injury are:
Several conditions has been blamed:
1.Repetitive movements of the knee-soccer players who use repetitive movements are at higher risk of Articular Cartilage Injury as well as meniscus tears.

2.Chronic wear and tear- with age the blood supply to the knee is reduced resulting in degeneration of the the articular cartilage of the knee.

3.trauma - injury to the articular cartilage such as a fall or direct hit to the knee

4.Obesity cause more weight bearing effect on the articular cartilage

The symptoms and signs of Articular Cartilage Injury are:
Symptoms:
1.Recurrent Pain in the knee

2.Swelling of the knee

3.Difficulty in bending or straightening the knee

4.audible clicks on knee movement

5.difficulty in walking because of the pain

Diagnosis:
1.history of a fall or injury followed by limitation of movement of the knee

2.MRI will show if there is articular cartilage damage

The Treatment of Articular Cartilage Injury is:
Conservative treatment:
1.rest,elevation and ice compress treatment of the knee upon injury

2.Pain killers such as NSAID(non-steroidal anti-inflammatory drugs) for pain relief and reducing inflammation

3.Muscle relaxant to relax muscles

4.crutches can reduce the weight off the affected limb

5.Physiotherapy such as traction, shortwave diathermy help to increase knee muscle strength and improve flexibility of movement of the knee

Surgery is usually indicated in Articular Cartilage Injury if the condition does not improve with conservative treatment.
1.A keyhole or arthroscopic microfracture repair is done to fill the defect in the cartilage with stem cells

2.Osteochondral graft transfer techniques where plugs of cartilage together with the bone foundation are taken from a less critical of the knee and transplanted to cover the defect in the cartilage.

3.Autologous cartilage implantation techniques where cartilage cells harvested from the knee , grown and multiplied in the laboratory are tranfered back into the joint to cover the defect.

Physiotherapy starts the day after surgery.

Prognosis depends on the severity of the cartilage injury

In most cases Articular Cartilage Injury may recover with conservative methods.
Some cases however may require surgical treatment

Prognosis is good after surgical treatment.

Prevention is to avoid weight bearing, reduce obesity and muscle strengthening exercises.