Articular cartilage is the cartilage lining on the ends of the bones. Cartilage can be injured from a specific injury. It can also wear out over time, leading to osteoarthritis. In this article, I discuss articular cartilage damage and arthritis. I also share some of the treatment options.

What is articular cartilage?

Articular cartilage is the cartilage lining the ends of the bones within the joints. It is a shock absorber. It aids in smooth movement of the joint.

Healthy articular cartilage in the knee

How can you injure your cartilage?

Articular cartilage could be injured with direct impact in an acute injury. In that circumstance, injury to the articular cartilage can be an isolated injury or coexist with injury to the ACL, meniscus, or other structures.

What is arthritis?

Articular cartilage damage can also occur with wear and tear over time. Gradual deterioration can lead to narrowing of the knee, shoulder, hip or other joint. The narrowing and other changes are features of osteoarthritis.

What symptoms are common?

Pain, swelling, and locking and catching within the joint are common. They can all limit a person’s function.

How can a doctor diagnose cartilage damage or arthritis?

The doctor examines the knee, hip, or other affected joint. He looks for tenderness, range of motion and more. X-rays can show narrowing between the bones in the joint. They can show spurs and other degenerative changes. X-rays can be normal after a traumatic injury or with early changes. An MRI or MR arthrogram (MRI performed with contrast injected into the joint) can show articular cartilage damage.

Cartilage damage in the knee
Note the frayed articular cartilage on the end of the femur (red arrow). This is the appearance of cartilage in more advanced arthritis.

How can you treat cartilage damage, or arthritis?

Articular cartilage has little blood supply. That is one reason articular cartilage injuries don’t heal on their own. Often nonoperative treatments work to decrease pain. Rest and modifying activities can relieve stress on the painful joint. Anti-inflammatory medications might help. Some patients try supplements like glucosamine and chondroitin. Braces, physical therapy, cortisone injections and PRP injections are possible treatment options as well.

Can surgery help cartilage damage?

If nonoperative treatments fail to provide relief, surgery might help. The type of surgery depends on the damage.

If there is an area of cartilage damage causing locking or catching, some surgeons might perform arthroscopic surgery. The surgeon can debride the loose cartilage. Microfracture might be an option too. It is a surgery to drill small holes in bone to stimulate the growth of fibrocartilage. Transfers of cartilage from other areas of the knee can be performed. Osteotomy, or surgery to cut and realign the bones to decrease stress on the area of damage, might be an option.

When is a hip or knee replacement needed for arthritis?

A joint can degenerate to the point where pain and function are severely impacted. A joint replacement (arthroplasty) surgery can replace worn-out bone and cartilage.

Damage to articular cartilage doesn’t heal. Some treatments can decrease pain. Visit an orthopedic surgeon. The doctor can diagnose your injury and offer you treatment options.

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