Cartilage damage 

Introduction 

Arthroscopy

Arthroscopy can be a safe and effective procedure for diagnosing and treating knee problems. Orthopaedic surgeon Mr Lawrence Freedman explains.

Media last reviewed: 21/10/2013

Next review due: 21/10/2015

Knee pain and other running injuries

The five most common running injuries, what to do if you get one, plus how to prevent injury

Cartilage damage is a relatively common type of injury. The majority of cases involve the knee joint.

Symptoms of cartilage damage include:

  • swelling
  • joint pain
  • stiffness
  • a decreased range of movement in the affected joint

Cartilage

Cartilage is a tough, flexible tissue found throughout the body. Cartilage serves two main functions:

  • it acts as a shock absorber
  • it acts as a mould

Cartilage covers the surface of joints, enabling bones to slide over one another while reducing friction and preventing damage. It helps to support your weight when you move, bend, stretch and run.

The tough, flexible cartilage tissue is ideal for creating specially shaped and curved body parts that would otherwise have no support from the bones. For example, most of the nose and the outside of the ears are made up of cartilage tissue.

Unlike other types of tissue, cartilage does not have its own blood supply. Blood cells help to repair damaged tissue, therefore damaged cartilage does not heal as quickly as damaged skin or muscles.

Types of cartilage

There are three types of cartilage. They are:

  • elastic cartilage
  • fibrocartilage
  • hyaline cartilage

These are described in more detail below.

Elastic cartilage

Elastic cartilage is the most springy and supple type of cartilage. This type of cartilage makes up the outside of the ears, some of the nose, and the epiglottis (the flap of tissue at the back of the throat, which prevents food going down into your airways).

Fibrocartilage

Fibrocartilage is the toughest type of cartilage and can withstand a great deal of weight. It is found between the discs (vertebrae) of the spine and between the bones of the hips and pelvis.

Hyaline cartilage

Hyaline cartilage, also known as articular cartilage, is both springy and tough. It is found between the ribs, around the windpipe (trachea) and between the joints.

Types of cartilage damage

All three types of cartilage can be damaged. For example, a blow to your ear can damage the elastic cartilage, making your ear look deformed. This condition is often seen in rugby players and is known as ‘cauliflower ear’.

The fibrocartilage between the discs in your back can also become damaged, resulting in a slipped disc.

One of the most common and potentially serious types of cartilage damage is damage to the articular cartilage between a joint (usually the knee joint). The damage can result in pain, swelling and some loss of mobility.

There are three main ways that the articular cartilage can be damaged:

  • as a result of a sudden accidental injury to the cartilage – for example, falling badly and landing on your knees
  • where a small section of cartilage and a piece of bone attached to it comes away from a joint – this is known as osteochondritis dissecans
  • long-term damage that occurs due to a process of ‘wear and tear’ – this type of long-term cartilage damage to the joints is known as osteoarthritis.

(The rest of this article focuses on articular cartilage damage.)

Read more about the causes of cartilage damage.

Treatment

Non-surgical treatments, such as physiotherapy and the non-steroidal anti-inflammatory drugs (NSAIDs) type of painkillers, are usually recommended for minor to moderate cases of cartilage damage.

In more serious cases surgery may be required. There are a number of surgical techniques available, such as encouraging the growth of new cartilage, or taking a piece of healthy cartilage from elsewhere in the body and using it to replace damaged cartilage.

In the most serious cases, the entire joint may need to be replaced with an artificial joint, such as a knee replacement or hip replacement.

Read more about the treatment of cartilage damage.

How common is cartilage damage?

It is hard to estimate exactly how common cartilage damage is because many people with mild cartilage damage do not seek medical help. However, cartilage damage is thought to be quite common.

Every year in the UK, around 10,000 people have cartilage damage serious enough to require treatment.

Cases of accidental cartilage damage are most common in people under 35 years old. This is because this age group is more likely to take part in sporting activities where there is a higher risk of injury.

Cartilage damage associated with osteoarthritis is more common in adults over 50 years old. It is also more common in women than in men.

Page last reviewed: 06/06/2012

Next review due: 06/06/2014

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Comments

The 8 comments posted are personal views. Any information they give has not been checked and may not be accurate.

GregC12 said on 12 February 2014

I have been diagnosed with advanced Arthritus in my right hip joint. My left joint appears to have a normal amount of cartilage and I don't have any acute problems elsewhere. My Physiotherapist, on inspection of the Xray, gave me 4 months to one year before hip replacement. I doing daily light exercises including10 mins bike riding and some in the pool. I'm not disabled (yet)
Is this common where joints are so different in the same person? I haven't ever inured either joint and I find the condition most intriguing, as if there is another local factor involved in my right hip, other than natural wear and tear.
My wife was talking to someone who had been to a medical conference where the presenter postulated that inflammation impedes the repair of cartilage
If this is correct (I don't know) then the natural conclusion should be that the control of inflammation should give one a better chance of growing the cartilage back (but I'm 64 y.o.)
I'm taking Mobic daily which seems to be working well with Panadol Osteo and even trying Glucosamine and Condrointin for a month
Has anybody seen any papers on this possible treatment i.e. repair resulting from inflammation reduction
Greg

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AngelaVG said on 30 October 2013

My left knee went about 3 months ago and I've been in agonising pain ever since. I saw the doctor, was referred to a physio. Had about 4 sessions with him, despite trying everything he could, nothing was working and he diagnosed that it was a torn meniscus. Went back to the doctors who then referred me to a specialist, I had to wait over 2 months for that appointment, still in total agony and barely able to walk or drive - great fun when you're a single mum who works full time! When I finally had my specialist appointment, they sent me off for an xray despite me saying it's a waste of time, I need an MRI. Nothing found on X Ray, now waiting for an MRI appointment. I've never had to deal with the NHS other than for simple GP appointments and quite frankly, I'm hugely dissapointed in the lack of understanding in getting my problem fixed quickly. I'm in tears every day and hardly able to sleep at night. The whole thing is a nightmare :(

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richiecat said on 15 August 2013

This is a message for researchers or professionals on osteoarthritis.

I was born in the year 1950.

I have been extremely meticulous about my diet over the last two years or so ensuring that I cut out inflammation causing food and eat the more non-inflammation causing food and I think my osteoarthritis is advancing.

It hasn't reached an advance stage yet for I'm still doing my jogging everyday and yes, play tennis. But I could feel something is not right with my knees and I can't bend down or stoop without feeling great discomfort.

Also, I have been getting this inflammation sensation on my finger joints lately. I don't see the redness but could feel some mild burning pain on my finger joints. I already have joint deformation on my last finger on both hands since about two years ago.

I searched all over the Internet for possible causes and try to follow all the positive advice.

However, there is one I have not been able to follow. Because of the nature of my work and lifestyle, I sit in front of my computer for over 12 hours a day almost every day, including weekends.

It was as from only a few days ago that I started getting up every so often after I read some advice on the Internet (I haven't been doing that previously).

Since I thought I've done just about everything I could to prevent cartilage loss except for sitting long hours, I suspect the inflammation I am getting is probably due to the extremely long hours seated on a chair.

Could some doctors or researchers confirm that? Or could there be something more?

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darmusadmiral said on 05 January 2012

Im 18 and also have had pain in my right knee it feels like a drill going through my knee this happens when im sat down i try to move my leg to adjust the position to see if that helps but it goes worse , the pain comes and goes ever hour or so maybe a little bit longer , any advice on what i should do?

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User629148 said on 02 January 2012

ive just had double knee operation,both knees had meniscus tears in,just watched that video and its taken me 7 weeks to get back to some normality,i still have a little niggle pains now and then,but i now can kneel,which i could not do for over a year,i do have to be care yet though,i have just started running again,yet a again carefully

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digitalFatteh said on 08 November 2011

I had a wonderful experience with my knee back in 2005 when the specialist told me to my face that He "Thought I was lying about the knee pain to get out of work but to prove it would require to waste resources in scanning the knee". Suffice to say they found a significant tear to the knee cartilage. I declined the offer of surgery from this specialist and continue to have mild pangs of aches now and then but its livable and continue to enjoy my working life fully.

If you should require someone to look into it get your GP to (A person I tend to avoid). I didn't and ended up through A&E (lost mobility during a work shift) and then onto the specialist. I continue to perform my own physio the upper leg muscles and enjoy a active life (not a car owner) so if I need to get about its walk and public transport.

As written within a previous comment get it seen to by your GP don't leave it until the last minute.

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angie85 said on 15 April 2010

My advice would be to go to your GP.

Im 24 and had cartiledge problems in my left knee when i was roughly around 11.
2 weeks ago i started getting a mild pain in my right knee so i went to my GP, he felt my knee and said although my knees were stable it sounded like Chondromalacia Patellae. I was referred to a physiotherapist who took some details of my pain and said they would be in touch with an appointment. I was prescribed Ibuprofen and Paracetamol for the pain, which at the time was unbareable. It was keeping me awake at night as my leg muscles felt like they were burning. The painkillers have helped ease the pain alot but i still feel really uncomfortable lying with my knees straight or sitting with my knees bent for long periods of time. I walked for a short while yesterday and now my knees have started to swell.

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ouchouchyouch said on 28 August 2009

hi, i have had problems with my knees since i was 12 and they said it was something to do with the cartalidge. Now I'm 20 and i'm in so much pain its unreal i cant even lie down comfortably. the pain has never been this bad and any pain killers i take wear off long before i can safely take any more. Ive done some research and think i have either Patellofemoral Pain Syndrome (PFPS) or Chondromalacia patellae (CMP)

do you have any suggestions that may help me?

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