Cartilage damage is one of the most common orthopaedic diseases. Sooner or later, it will affect almost everyone. At the latest when age-related joint wear occurs, cartilage degradation is part of the normal course of time. However, active and sporty people in particular can be affected by cartilage damage at a young age.
The good news is that cartilage damage can be successfully treated and long-term damage avoided for as long as possible if it is recognised in good time and treated in a targeted manner. As in many cases, the combination of the treating doctor’s experience and the latest medical treatments are the key to success.
The joint experts at ECOM® specialise in the treatment and therapy of cartilage damage and are renowned nationally and internationally.
Cartilage damage can occur in any joint, but the knee and hip joints are most commonly affected. The treatment options for cartilage damage depend on the type of joint affected and the individual extent and depth of the damage. There are therefore no standard solutions.
The joint experts at ECOM® use various highly specialised procedures for the individual treatment of cartilage damage, which can be applied to the affected joints individually or in combination:
– Conservative therapy
– Regenerative therapy (e.g. stem cell therapy)
– Joint cleaning
– Microfracturing
– Cartilage transplantation
– Cartilage cell transplantation
– Joint replacement
Articular cartilage is an important part of the joints. It covers the surface of bones and acts like a shock absorber: it cushions impacts and prevents bones from colliding directly with each other. This works optimally as long as the joint cartilage remains undamaged.
Cartilage damage is usually caused by incorrect and excessive strain, poor posture or accidents. Too little exercise also damages the joint cartilage, as only movement stimulates the natural supply of nutrients.
The special problem in the treatment of cartilage damage is the lack of regenerative capacity of cartilage tissue: cartilage cells are not naturally capable of regeneration. Unlike bone or muscle tissue, self-healing is not possible.
The treatment of cartilage damage is one of the greatest challenges for modern orthopaedics. Experience and expertise, using the latest medical standards, are the prerequisites for successful treatment of cartilage damage.
The causes of cartilage damage vary. Basically, we differentiate between acute and chronic cartilage damage.
Acute cartilage damage
Acute cartilage damage is often the result of injuries. The cartilage is usually only damaged to a greater or lesser extent at one point. Young patients or people who are active in sports are usually affected. Long-term incorrect or excessive strain during sport can lead to chronic cartilage damage.
Chronic cartilage damage
Chronic cartilage damage is the result of permanent wear and tear of the cartilage. They are usually more extensive and localised in different places. The causes of cartilage wear and tear vary from person to person. On the one hand, they depend on the type and severity of the trauma and the physical strain, but on the other hand they are also influenced by the quality of the joint cartilage. Misalignments such as bowlegs and knock-knees or obesity can also lead to premature wear and tear.
Cartilage damage can be very painful, but paradoxically it doesn’t have to be. The reason: the cartilage layer itself is completely insensitive to pain. Cartilage defects are therefore often only perceived as painful when the cartilage layer has already been worn away and destroyed and bones are rubbing against each other without protection.
The location of the cartilage damage is decisive for the symptoms of cartilage damage. If it is located in areas subject to heavy strain, symptoms are more likely to occur than if the damage is in areas subject to less strain. Another important factor influencing the symptoms of cartilage damage is the extent or size of the cartilage defect.
The key factor in cartilage damage is that the cartilage’s ability to regenerate is very limited. Once the cartilage is damaged, it hardly regenerates on its own. Injured or destroyed cartilage does not grow back in its original form. To make matters worse, damaged cartilage – if left untreated – usually spreads further. However, if diagnosed and treated in good time, cartilage damage can be successfully halted in many cases and consequential damage avoided.
Imaging procedures such as magnetic resonance imaging (MRI) show whether and to what extent cartilage damage is present and whether neighbouring tissue structures are affected. If cartilage damage is present, it is categorised. We differentiate between four different stages:
Grade I: Discolouration of the cartilage, softening of the cartilage
Grade II: Tears in the cartilage
Grade III: Cartilage defects that extend to the bone
Grade IV: Absence of the cartilage layer, exposed bone
Each case of cartilage damage is individual and must be treated separately. The extent of the existing cartilage damage, the quality of the joint cartilage, the age of the patient and the personal stress level are decisive for the appropriate therapy.
Young and active people or athletes are usually treated with more specialised methods in order to be able to mobilise their personal load and movement possibilities again.
The joint experts at ECOM® use various highly specialised procedures for the individual treatment of cartilage damage, which can be used individually or in combination.
At an early stage of cartilage damage, conservative therapy can help to prevent the joint situation from deteriorating. It usually consists of a combination of physiotherapy, drug therapy and orthopaedic, stabilising aids.
Innovative methods can be used to achieve cartilage regeneration in young patients with incipient cartilage damage. This utilises the body’s self-healing process, which heals the joint damage using the body’s own resources.
Possible procedures include stem cell therapy using the body’s own stem cells from blood or fatty tissue, microfracturing, cartilage cell transplantation or cartilage transplantation.
During cartilage smoothing (by arthroscopy), torn and protruding cartilage fibres are removed and smoothed, preventing further tearing. In many cases of joint damage to the knee, there is also damage to the meniscus. In this case, the damaged meniscus tissue is either removed (partial meniscus resection) and smoothed (meniscus smoothing) or sutured (meniscus suture) as part of a joint clean-up. Meniscus suturing is particularly recommended for young and athletically active people, as this preserves the entire meniscus.
Fracturing in the case of cartilage damage is also known as microfracturing. This involves refreshing the defective cartilage substrate and stimulating the formation of new replacement cartilage. Microfracturing is suitable for defects where there is little to no cartilage left and the bone is completely exposed. In this exposed bone area, small holes a few millimetres deep are punched into the bone in a regular pattern every few millimetres.
The artificially created defects stimulate the bone marrow to form cartilage tissue. For this purpose, a blood-like substance containing stem cells is released from the punched holes in the bone and forms replacement cartilage tissue. The replacement cartilage tissue fills the cartilage defect, but is not as resilient as the original cartilage tissue.
The artificially created defects stimulate the bone marrow to form cartilage tissue. For this purpose, a blood-like substance containing stem cells is released from the punched holes in the bone and forms replacement cartilage tissue. The replacement cartilage tissue fills the cartilage defect, but is not as resilient as the original cartilage tissue
Cartilage transplantation for cartilage damage is also known as cartilage transplantation, cartilage-bone transplantation or mosaicplasty. During the procedure, pieces of cartilage are taken from less stressed areas and inserted into a damaged area. Cartilage transplantation is considered for smaller, localised cartilage damage. The smaller the defect, the better the chances of successful treatment. The age of the patient also plays an important role.
As the healing process in the joint deteriorates with increasing age, the procedure is generally only recommended for younger patients under the age of 50. In addition, there should be no accompanying damage to the joint, such as meniscus damage. Being extremely overweight can also have a negative effect on the success of the treatment.
The transplantation of cartilage cells in the event of cartilage damage is also known as cartilage cell transplantation. Cartilage defects are closed using cartilage cells cultivated in the laboratory.
In cartilage cell transplantation, healthy cartilage cells are removed from a joint in an initial operation. These are then multiplied using laboratory procedures. After two to three weeks, the grown cartilage cells have reached the desired size and number so that they can be transplanted into the patient in a further operation on the damaged cartilage. Cartilage cell transplantation is generally suitable for younger patients with a fresh, traumatic cartilage defect. However, the complexity and costs of the procedure are high and are only covered by selected private health insurance companies.
If a cartilage defect is too advanced or if cartilage-preserving or cartilage-regenerating therapies have not been successful, an artificial joint is a sensible alternative. Joint replacement is one of the most important medical achievements and is one of the most frequently performed orthopaedic operations. It gives affected patients back their mobility and quality of life and often helps them to lead a new life. Experienced specialists can draw on a broad spectrum of endoprosthetics and help to find the right time for a joint replacement for the individual patient.
Rehabilitation is of crucial importance after cartilage surgery. This is because the joint cartilage itself is not connected to the circulatory system and is therefore not nourished directly by the blood. This task is performed by the synovial fluid, which is also known as the cartilage’s nutrient solution.
Joint fluid is produced through movement. A correctly dosed form of exercise in each phase of wound healing therefore helps to stimulate the cartilage cells. Targeted physiotherapy and training therapy treatments optimise the healing process and support the regeneration of the cartilage tissue.
Close cooperation between the doctor and physiotherapist is an essential part of rapid regeneration after cartilage surgery. The experts at ECOM® therefore work together with the responsible therapists to develop a customised rehabilitation concept. Always with the aim of getting patients back into sport and everyday life as quickly as possible.
Specialist in orthopaedics and trauma surgery
Specialist in orthopaedic surgery
„The patient is often in a state of emergency. Targeted diagnosis and individualised therapy are the key to successful treatment“.
Specialist in orthopaedics and trauma surgery
ZB Sports medicine, chirotherapy
„Arthroscopy has revolutionised joint-preserving hip surgery and enables new treatments for hip problems.“
Specialist in orthopaedics and trauma surgery Additional qualification in manual therapy
Do you have questions about the treatment and therapy of an acute or chronic cartilage injury?
Our experts Dr Alexander Rauch, Prof Dr Hans Gollwitzer and PD Dr Julian Mehl will be happy to provide you with detailed information and advice in a personal consultation. Simply make an appointment. We look forward to hearing from you.
Cartilage damage refers to wear or injury of the articular cartilage, which acts as a shock absorber between the bones. Common causes include incorrect or excessive loading, accidents, lack of exercise, and age-related wear.
Typical symptoms include joint pain, restricted movement, and a feeling of instability. Because cartilage itself has no pain receptors, pain often occurs only when surrounding structures are affected.
Diagnosis is based on a clinical examination and imaging techniques such as MRI. Cartilage damage is classified into four grades, ranging from slight softening of the cartilage (Grade I) to complete loss of the cartilage layer (Grade IV).
In the early stages, physiotherapy, anti-inflammatory medication, and orthopaedic aids may help. The aim is to maintain joint function and prevent further deterioration.
Depending on the extent of the damage, procedures such as microfracture, cartilage smoothing, cartilage transplantation, or cartilage cell transplantation may be used. In advanced cases, joint replacement may be necessary.
Cartilage tissue has only a very limited ability to regenerate. However, innovative treatments such as stem cell therapy or cartilage cell transplantation may stimulate the formation of replacement cartilage, particularly in young and active patients.
Rehabilitation is individually tailored and includes physiotherapy and exercise therapy. Because cartilage receives nutrients through synovial fluid, targeted movement plays an important role in the healing process.
Sehr geehrte Besucher,
Sie verlassen nun den Internetauftritt der ECOM® – Praxis für Orthopädie, Sportmedizin und Gelenkchirurgie – Ärztepartnerschaft aus München.
Sie werden weitergeleitet auf den Internetauftritt von ECOM – Zentrum für Regenerative Medizin und Stammzelltherapie Dr. Alexander Rauch, Prof. Dr. Hans Gollwitzer, Prof. Dr. Patrick Weber in Thiersee, Österreich.
Die im folgenden beschriebenen Therapien finden ausschließlich in Österreich statt und sind von der Ärztekammer Tirol, sowie der Österreichische Agentur für Gesundheit und Ernährungssicherheit (AGES) genehmigt.
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