Test for possible arthrosis
Cartilage damage in the various joints
Cartilage damage to the knee joint is not uncommon. Natural wear and tear occurs in the course of life. The knee joint is challenged throughout life by everyday walking and standing.
In addition, further wear and tear is caused by other stressful activities such as sports, malpositioning of the knee joint and injuries to the bone and ligament structures of the knee joint. The chronic degradation and defect of cartilage in the knee is known as gonarthrosis. This lack of cartilage manifests itself in the form of pain when the knee is loaded and later also at rest.
In addition, the knee is also restricted in its mobility. In addition to the degenerative variant of cartilage degeneration described above, cartilage damage can be traumatic (accident-related). This often occurs in the course of sports and fall injuries.
In this case, a piece of cartilage a few centimeters in diameter breaks out of the cartilage surface. However, the remaining cartilage of the knee is still intact, as is the underlying bone. With this form of cartilage damage, there are good therapeutic options for restoring an intact cartilage surface.
In both forms of cartilage damage, relief of the knee is indicated. This means that the patient with gonarthrosis should reduce stressful activities (sports, poor posture, carrying heavy weight) in the long term. In the case of traumatic cartilage damage, unnecessarily stressful activities for the knee joint should also be avoided during the period of regeneration and therapy.
In both cases, physiotherapeutic treatment can be helpful to reduce pain and problems. Another risk zone for cartilage damage in the knee area is the cartilage between the kneecap and the joint bones. This is where over-irritation and damage to this cartilage zone occurs due to incorrect loading of the knee.
Often this condition is caused by malpositions in the knee joint, shortened muscles and also permanent overloading by running and cycling, therefore it is also called runner’s knee. This pain condition can last for several weeks and can lead to impairment of normal walking. The therapy here consists of a training break, voltar bandages, ice packs and stretching exercises for the muscle groups that stabilize the knee and trunk.
Furthermore, attention should be paid to the choice of running shoes. If the problem does not improve, a cortisone injection into the knee and, in exceptional cases, surgical intervention may be necessary. In contrast to other joints, the hip joint has a relatively thin layer of cartilage.
This is essential for the lifelong functionality of the hip joint. Damage to the cartilage can be degenerative, just like in other joints. This means that they develop over the course of a lifetime as a result of stress and wear and tear.
This results in arthrosis. However, cartilage damage to the hip can also be caused by trauma. Excessive and incorrect loading of the joint, e.g. during sports, an accident or a fall, can injure the cartilage and break off parts of it.
In the course of time, such a relatively minor injury can develop into a chronic problem. The original injury usually involves a relatively small area of cartilage, while cartilage damage that develops over years tends to affect larger parts of the cartilage. Other causes of cartilage damage to the hip can be found in metabolic disorders such as gout.
This is where small crystals of substances are deposited in the joint that the body can no longer excrete sufficiently, causing pain and further wear and tear on the cartilage. Some bacteria cause chronic damage to joints, including the hip joint, in the course of infection.This is an arthritis caused by bacteria. Here the problem should be reduced by a correctly selected antibiotic therapy.
The ankle joint has to hold the complete body weight during movement and rest. The cartilage is exposed to constant stress and is therefore subject to a lot of strain. The joint is often exposed to great external forces, which can lead to compression of the cartilage, as well as injuries to cartilage and other joint structures.
Compression of the cartilage can lead to severe bruising and tearing. Furthermore, it can also lead to chipping of cartilage. Other injuries to the ankle joint such as supination traumas (bending outwards) and injuries to bones and ligament structures also often affect the cartilage.
In addition to crush and tear injuries, there is also the risk of bone fragments splintering off and causing acute or long-term damage to the cartilage. Affected persons often have a limited load-bearing capacity and mobility of the affected foot. Pain and instability also occur, which may be related to the injury to other structures.
In the course of aging, the shoulder joint is often the site of pain and thus responsible for difficulties in movement. This is often caused by damage to tendons of muscles of the rotator cuff. But the cartilaginous area of the joint, the cavitas glenoidalis, can also be affected by wear and tear.
Another reason for complaints are acute traumatic events such as falls and accidents, in which large forces act on the joint and damage parts of the cartilage. However, cartilage damage is also often found in long-term overloading of the shoulder joint in the course of practiced sports in which the shoulder is overloaded by one-sided and frequently performed movements (tennis) or in which unnatural pulling and pushing movements are performed against the shoulder joint at regular intervals (football). Furthermore, persons who practice weight training over a longer period of time show heavy wear and tear.
The first signs of damage often appear in the form of restricted movement, painful movements, cracking in the joint, swelling and weakness. In order to be able to assess the cartilage damage more accurately, an X-ray image can be taken and a magnetic resonance tomography (MRT) can be performed. However, the existing defect can be determined even more precisely by means of arthroscopy.
This is a minimally invasive surgical technique, which has the advantage that it can not only be used for diagnostic purposes, but also offers direct access to some therapeutic approaches. During this procedure, if necessary, bone or cartilage parts can be removed, the cartilage smoothed and the joint cleaned and rinsed (lavage or debridement). In the case of less pronounced changes, physiotherapy may be sufficient to enable the patient to live a life free of complaints.
Painkillers and/or shoe insoles can be used to accompany the treatment. In addition, it is of course important that all risk factors are eliminated or reduced as far as possible. Overweight should be reduced, strenuous sports and other overexertions should be avoided, and underlying diseases or malpositions should be eliminated.
If these measures do not suffice to significantly improve the symptoms, there are several newer methods to combat cartilage damage: Especially in younger patients, it is advisable to transplant healthy cartilage tissue that has previously been removed from less affected parts of the joint. In addition, there are completely new drugs on the market that inhibit very specifically certain inflammatory triggers that are partly responsible for the damage to the joint cartilage. Although these are currently still being tested and are very expensive, they promise to be very successful.
Last but not least, it should be mentioned that cartilage cultivation is currently being researched. It is now possible to cultivate cartilage cells from blood stem cells in the laboratory and such cartilage cultures with subsequent transplantation are already being successfully carried out in some areas of Germany.