SPORTS TIP Articular Cartilage Injuries EXPERT CONSULTANTS: Daniel Romanelli, MD, John Uribe, MD, Diane S. Watanabe, ATC, Bert R. Mandelbaum, MD What is articular cartilage? Mechanical degeneration (wear and tear) Articular cartilage can sometimes of articular cartilage occurs with the be confusing, because there are three progressive loss of the normal cartilage different types of cartilage found in structure and function. This initial loss the body: articular or hyaline cartilage begins with cartilage softening then (covers joint surfaces), fibrocartilage progresses to fragmentation. As the loss (knee meniscus, vertebral disk), of the articular cartilage lining continues, and elastic cartilage (outer ear). These the underlying bone has no protection different cartilages are distinguished by from the normal wear and tear of daily their structure, elasticity, and strength. living and begins to break down, leading to osteoarthritis. Articular cartilage is a complex, living tissue that lines the bony surface of joints. How often does an articular Its function is to provide a low friction cartilage injury occur? surface enabling the joint to withstand weight bearing through the range of In many cases, a patient will experience motion needed to perform activities of knee swelling and vague pain. At this daily living as well as athletic endeavors. point continued activity may not be In other words, articular cartilage is a very possible. If a loose body is present, How is an injury treated? words such as “locking” or “catching” thin shock absorber. It is organized into Injuries to the cartilage that do not might be used to describe the problem. five distinct layers, with each layer having extend to the bone will generally not With wear and tear, the patient often structural and biochemical differences. heal on their own. Injuries that penetrate experiences stiffness, decreased range to the bone may heal, but the type of of motion, joint pain, and/or swelling. What causes an articular cartilage that is laid down is structurally cartilage injury? unorganized and does not function as How is an articular cartilage Articular cartilage injuries can occur as well as the original articular cartilage. defect (injury) diagnosed? a result of either traumatic or progressive Defects smaller than 2 cm have the best degeneration (wear and tear). With The physician examines the knee, prognosis and treatment options. Those mechanical destruction, a direct blow looking for decreased range of motion, options include arthroscopic surgery or other trauma can injure the articular pain along the joint line, swelling, fluid using techniques to remove damaged cartilage. Depending on the extent of the on the knee, abnormal alignment of the cartilage and increase blood flow from damage and the location of the injury, bones making up the joint, and ligament the underlying bone (e.g. drilling, pick it is sometimes possible for the articular or meniscal injury. Injuries to the procedure, or microfracture). For smaller cartilage cells to heal. Articular cartilage articular cartilage are difficult to diagnose, articular cartilage defects which are has no direct blood supply, thus it has and evaluation with MRI (magnetic asymptomatic, surgery may not be little or no capacity to repair itself. If the resonance imaging) or arthroscopy required. For larger defects, it may be injury penetrates the bone beneath the may be necessary. Plain X-rays are necessary to transplant cartilage from cartilage, the underlying bone provides not usually good in diagnosing articular other areas of the knee (joint). Consult some blood to the area, improving cartilage problems but are usually your specialist for further information the chance of healing. taken to rule out other abnormalities. on the decision to have surgery. Sports Tips are brought to you by the American Orthopaedic Society for Sports Medicine. They provide general information only and are not a substitute for your own good judgement or consultation with a physician. To order multiple copies of this fact sheet or learn more about other orthopaedic sports medicine topics, visit sportsmed.org. Copyright © 2016. American Orthopaedic Society for Sports Medicine. All rights reserved. Multiple copy reproduction prohibited. Articular Cartilage Injuries For patients with osteoarthritis, non- surgical treatment consists of physical therapy, lifestyle modification (e.g., reducing activity), bracing, supportive devices, oral and injection drugs (i.e., non-steroidal anti-inflammatory drugs, cartilage protective drugs), and medical management. Surgical options are very specific to osteoarthritis severity and can provide a reduction in symptoms that are generally only short lived. Total joint replacement can provide relief for the symptom of advanced osteoarthritis, but generally requires a change in a patient’s lifestyle and/or activity level. Sports Tips are brought to you by the American Orthopaedic Society for Sports Medicine. They provide general information only and are not a substitute for your own good judgement or consultation with a physician. To order multiple copies of this fact sheet or learn more about other orthopaedic sports medicine topics, visit sportsmed.org. Copyright © 2016. American Orthopaedic Society for Sports Medicine. All rights reserved. Multiple copy reproduction prohibited..