What is cartilage damage?

This guide to cartilage damage will help you understand what cartilage is, how cartilage damage occurs, and what you can do about it. We will cover:

What cartilage is and its functions
Symptoms of cartilage damage
Diagnosis of cartilage damage
Treatments for cartilage damage, including non-invasive, minimally invasive, and surgical

Cartilage damage is quite common and can be difficult to diagnose. Since damage varies significantly from person to person, it may also take time to find the right treatment. But effective treatments do exist.

What is Cartilage?

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.

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.

What Does Cartilage Do?

Initially, cartilage serves as the framework for bone growth from inside the womb until we are fully grown. The other main function of cartilage is to support, cushion, and reduce friction between bones and joints. In many ways, it acts as a shock absorber and smooth surface to aid in mobility.

Cartilage functions:

Provide framework for bone growth
Support the body as a shock absorber
Improve mobility and flexibility
Provide attachment sites for muscles
Protect underlying tissues

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

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 rugby, wrestling, and American football are most at risk. However, player contact on the football field is quite common and often results in injury.
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.

Diagnosis of Cartilage Damage

It is difficult to tell the difference between cartilage damage and ligament damage (such as a sprain) because the symptoms can be similar. A doctor will complete a physical exam but then will likely recommend non-invasive tests to form a better diagnosis.

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

Treatment for cartilage damage can range from rest to surgery. For mild injuries, doctors may recommend rest, weight loss, over-the-counter pain medication, and specific exercises or physical therapy. For more serious pain or injuries, doctors usually suggest more conservative, less-invasive treatments before jumping to 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:

Surgical Treatments

Doctors usually suggest surgery as a last resort. There are several surgical treatments with varying degrees of risk. Some surgical treatments for repairing and relieving pain from cartilage damage include:

Marrow Stimulation
Mosaicplasty and Allograft Osteochondral (AOT)
Arthroscopic Lavage and Debridement
Autologous Chondrocyte Implantation (ACI)
Artificial Scaffold

Conclusion

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 specialises in joint pain to determine your best options.