Why are athletes at risk of cartilage injury and their scope after?
What is Cartilage?
Cartilage is the tough, flexible layer of tissue found in our joints. Cartilage is why we can bend our knees and elbows so smoothly and how our bodies can absorb shock when we run and jump.
Unfortunately, cartilage is easy to damage—a wrong twist, a sudden fall, or even wear and tear over time can all result in cartilage injuries. In addition, these injuries can’t heal naturally because cartilage doesn’t receive blood flow to repair itself. Cartilage injuries are most common in the knee, though they can happen in other joints, too.
What is Cartilage Injury?
The slippery articular cartilage that coats your bones helps with smooth movement.
If it’s torn or worn, it can leave the rough bone surfaces exposed – resulting in friction in the joint. In addition, damaged cartilage can potentially lead to knee arthritis, with long-term effects on your knee function.
Damaged cartilage almost always has some effect on your knees – whether it’s pain, swelling or stiffness.
Symptoms of a Cartilage Injury
Signs and symptoms of a cartilage injury might appear gradually over time or might occur suddenly after an accident or fall. Be on the lookout for:
- Joint pain, sometimes even when you’re sitting or laying down
- Stiffness, which can make it hard to bend your knee or elbow
- Swelling, redness, and a joint that may feel warm to the touch
- Joint weakness or instability
- A clicking, grinding or catching feeling in your knee
If it’s hard to do daily activities because of pain or you can’t walk or put weight on your leg, it’s time to contact an orthopaedic surgeon.
Can damaged cartilage repaired itself?
Cartilage can’t repair itself after it’s been damaged because it doesn’t have a source of blood flow to promote healing. Some chondrocytes (cartilage cells) can regenerate naturally, but most injuries need treatment from a medical professional to heal.
Causes And Risk Factors
The Thrower’s Shoulder is often called Internal impingement and primarily affects younger athletes. Internal impingement occurs during the “cocking” phase of throwing (like a cricket bowler).
As the athlete cocks their shoulder and arm back, the rotator cuff tendons get pinched between the glenoid labrum and the humeral head. This may lead to a partial rotator cuff tendon tear or damage the labrum with time.
Apart from lack of experience, the following risks were identified in a study by Olsen et al. when they surveyed 14-20-year-old baseball players to determine possible risk factors.
Who’s at risk of cartilage damage?
Anyone can potentially damage their cartilage, but injuries are most common in athletes who put a lot of stress on their joints. Older adults who have arthritis are also at risk.
Athletes in high-impact sports—like football, basketball, soccer, and tennis—are often injured due to accidents on the court or field or poor form when making a manoeuvre. In addition, injuries are often caused by:
- Hitting your knee directly on a hard surface
- Twisting or bending awkwardly
- A bad fall or poor landing after jumping
- Overextending or straining your knee
- Gradual wear-down from repetitive motions or overuse
Treatment Options for Cartilage Injuries
Treatment will depend on the severity of your injury. Some mild injuries may heal on their own with rest, but always be sure to consult with a doctor if you’re concerned about pain. Cartilage damage can lead to severe joint pain and arthritis over time if left untreated.
Treatment options include:
- The RICE method. RICE stands for rest, ice, compression, and elevation. This method involves taking a break from sports and exercising for a few days to let minor strains and sprains heal, though it can’t repair significant injuries. Learn more about the RICE method from the Mayo Clinic.
- Physical therapy. Physical therapy strengthens the muscles around your joints, which helps reduce pain and prevent future injuries.
- Injections. Platelet-rich plasma (PRP) injections can help manage pain and promote healing using platelets taken from your blood.
- Surgery. When a cartilage injury can’t heal on its own, your doctor may recommend surgery to repair the damage. The kind of surgery that will work for you will depend on the severity of your injury.
If rest doesn’t resolve your symptoms after a few days or your pain interferes with your daily life, talk to an orthopaedic doctor. They can perform exams and order imaging scans (like an x-ray or MRI) to better look at the injury and make a treatment plan.
Types of Surgery for Cartilage Injuries
There are many different surgeries designed to fix cartilage. Your orthopaedic surgeon will recommend what’s best for you after evaluating your injury, medical history, and activity level.
- Microfracture. This technique involves poking small holes in the bone beneath the cartilage. These holes let in a source of blood flow, which promotes healing in the cartilage cells.
- Osteochondral transfer system (OATS), also called mosaicplasty, involves taking a piece of healthy cartilage from your knee and replacing a damaged piece. Your surgeon may use tissue from a donor’s knee if there isn’t enough healthy tissue from your knee to use.
- Meniscus repair. If you’ve severely damaged your meniscus (the shock-absorbing cartilage between your shin and thigh), your surgeon may try to repair it or transplant a healthy meniscus from a donor.
- Autologous chondrocyte implantation (ACI). For an ACI procedure, your surgeon will take a sample of your cartilage cells to grow them into a custom-made implant. ACI is often recommended for younger athletes.
Is complete recovery possible after Cartiledge damage?
According to Kai Mithoefer
Twenty studies describing 1363 patients were included in the review, with an average follow-up of 42 months. Return to sports was possible in 73% overall, with the highest return rates after osteochondral autograft transplantation—time to return to sports varied between 7 and 18 months, depending on the cartilage repair technique. Initial return to sports at the preinjury level was possible in 68% and did not significantly vary between surgical techniques. Continued sports participation at the preinjury level was possible in 65%, with the best durability after autologous chondrocyte transplantation. Several factors affected the ability to return to sport: athlete’s age, preoperative duration of symptoms, level of play, lesion size, and repair tissue morphology.
Cartilage injury can become worse if not cared for properly. If you are experiencing any of the above symptoms or can’t find relief with non-surgical methods and home remedies, book an appointment with Dr Reetadyuti Mukhopadhyay, the shoulder specialist at our orthopaedic clinic Gurgaon.