Cartilage damage is a relatively common type of injury. It often involves the knees, although joints such as the hips, ankles and elbows can also be affected.
Cartilage is a type of connective tissue found in many parts of the body. It is firm, flexible, and is often described as rubbery. Once a person is full-grown, cartilage stops growing. You may have heard that cartilage continues to grow, which is why older people have larger noses and ears, but that is inaccurate.
The elastin fibers in cartilage break down over time and, combined with gravity, stretch over time. So, noses and ears do become larger with age, but that’s due to stretching, not growing. Cartilage breaking down from age and wear and tear also leads to joint pain and arthritis
It can become damaged as a result of a sudden injury, such as a sports injury, or gradual wear and tear (osteoarthritis).
Minor cartilage injuries may get better on their own within a few weeks, but more severe cartilage damage may eventually require surgery.
Three Types of Cartilage
There are three types of cartilage: elastic, fibrocartilage, and hyaline.
- Elastic Cartilage (a.k.a. yellow cartilage): the most spongy and springy cartilage. Found in the external ear, nose, and epiglottis (the flap in the throat that prevents food from entering your windpipe or lungs).
- Fibrocartilage: the strongest cartilage. Found between bones that carry the most weight or bear the most pressure, such as pelvic bones, hip bones, the knee, and between the vertebrae.
- Hyaline Cartilage: the most common cartilage. Found on many joint surfaces (articular cartilage) and in the ribs, nose, larynx, trachea. The breakdown of articular cartilage results in osteoarthritis.
Symptoms of cartilage damage
Although cartilage is quite tough, it is relatively easy to damage, especially in joints. After all, it is located in the parts of our body that experience the most pressure and strain. Cartilage damage is most common in knees but is also common in hips, ankles, and elbows.
Symptoms of Cartilage Damage in a joint:
- Joint pain (typically worsens when you put weight on it)
- Swelling
- Stiffness
- Clicking or Grinding
- Joint locks, catches, or gives way
It can sometimes be difficult to tell a cartilage injury apart from other common joint injuries, such as sprains, as the symptoms are similar.
Most Common Causes of Cartilage Damage
Since cartilage is present in our high-use areas of the body, there are countless ways you can injure it. You can damage your cartilage from stepping wrong or twisting wrong while playing sports or even walking. Car accidents often lead to cartilage damage in the wrists, ankles, and back. And good old wear and tear damages cartilage over time.
- Heavy Impact or Direct Blow: Typically, from a bad fall, auto accident, or sports impact. Athletes involved in contact sports like football, wrestling, and cheerleading are most at risk.
- Wear and Tear: frequent or consistent stress on a joint lead to wear and tear. This can occur through normal use over the years. But above-average wear and tear can occur from sports involvement. People who are taller or heavier than average are at risk of above-average wear and tear due to the added stress on their joints.
- Lack of Movement: inactivity can be detrimental as well. Joints need to move regularly to stay healthy. Lack of movement makes the cartilage more susceptible to damage.
When to get medical advice
If you’ve injured your joint, it’s a good idea to try self care measures first. Sprains and minor cartilage damage may get better on their own within a few days or weeks.
More severe cartilage damage probably will not improve on its own. If left untreated, it can eventually wear down the joint.
Visit your doctor if:
- you cannot move the joint properly
- you cannot control the pain with ordinary painkillers
- you cannot put any weight on the injured limb or it gives way when you try to use it
- the injured area looks crooked or has unusual lumps or bumps (other than swelling)
- you have numbness, discolouration, or coldness in any part of the injured area
- your symptoms have not started to improve within a few days of self-treatment
The most common diagnostic tests for cartilage damage are MRI and arthroscopy. MRIs can’t always detect cartilage damage but they provide detailed images of the injured area. Arthroscopy inserts a scope into the joint to examine and possibly repair it. Both procedures can help determine the existence and extent of cartilage damage.
Treatments for cartilage damage
Self care measures (R.I.C.E) are usually recommended as the first treatment for minor joint injuries.
For the first few days:
- protect the affected area from further injury by using a support, such as a knee brace
- rest the affected joint
- elevate the affected limb and apply an ice pack to the joint regularly
- take ordinary painkillers, such as Tylenol or Ibuprofen
Get medical advice if your symptoms are severe or do not improve after a few days. You may need professional treatment, such as physical therapy, or possibly surgery.
Minimally Invasive Treatments
Less invasive treatments include physical therapy, non-steroid anti-inflammatory drugs (NSAIDS), steroid injections, or orthobiologic injections. These treatments are not a cure, but they can drastically reduce the pain and improve mobility.
Orthobiologic treatments are relatively new but are showing excellent results in clinical trials as well as patient testimonials. Biologics come from or contain components of living organisms. In many cases, orthobiologic medications used for joint pain are made from the patient’s own biological material. The most promising orthobiologics are:
A number of surgical techniques can be used, including:
- encouraging the growth of new cartilage by drilling small holes in the nearby bone
- replacing the damaged cartilage with healthy cartilage taken from another part of the joint
- replacing the entire joint with an artificial one, such as a knee replacement or hip replacement – this is usually only necessary in the most severe cases.
Cartilage damage can be debilitating. The pain and limited mobility can keep you from doing your job, as well as the things you love. Thankfully, there are many kinds of treatments you can try before resorting to surgery. But every case is different. Your best course of action is to consult a doctor who specializes in joint pain to determine your best options.