Sports Medicine & Sports Surgery

Cartilage Injuries and Cartilage Repair Procedures

Articular cartilage is a specialised connective tissue and provides a smooth glistening layer over the articular surfaces of the bones that are involved in the formation of a joint. Hyaline cartilage functions to provide a frictionless articulating surface and to provide shock absorption during compressive loads. Hyaline cartilage is composed of a network of collagen fibres and proteoglycan matrix with a few cells interspersed within the substance of the cartilage. The problem with articular cartilage is that is has no nerve supply nor blood supply and therefore injured articular cartilage fails to heal properly. Articular cartilage can be damaged by a single traumatic event such as a dislocation of the patella or can occur as a result of repeated micro trauma. Patients with articular cartilage damage present with pain, swelling, occasional instability and may present with locking and giving way particularly if there is a separated articular cartilage fragments floating loose within the joint. Certain investigations may be required to diagnose articular cartilage injuries and these include x-rays, MRI scans and diagnostic arthroscopy. There are a number of surgical procedures that can be used to treat damaged articular cartilage and this includes

• Debridement and washout
• Micro fracture and drilling procedures
• Osteochondral grafting techniques
• Autologous chondrocyte implantation
• The use of artificial Matrices
• Osteotomy and joint replacement surgery

Articular cartilage injuries are quite common and often pose difficulties both in diagnosis and treatment. As you can see there are a variety of surgical procedures that can be used to treat articular cartilage defects but the choice of treatment depends upon the age and mechanism of the injury, the site, the presence or absence of associated injuries and the previous treatment received.

All the above techniques are routinely performed at the Orion Clinic.