Cartilage protects the joints and ensures that our movements run smoothly. This only becomes apparent when cartilage damage - and therefore joint pain - occurs due to wear and tear. Modern cartilage surgery offers innovative surgical procedures to restore damaged or destroyed cartilage.
Here you will find further information and selected cartilage specialists for cartilage surgery.
Cartilage surgery involves joint-preserving procedures for cartilage augmentation and cartilage reconstruction.
Cartilage surgery is a special treatment area within the medical specialties of orthopaedics and trauma surgery. Depending on the joint affected, cartilage surgery is divided into the following specialties
The bones of our joints are covered with a protective layer of cartilage that has unsurpassed gliding properties. It ensures that there is as little friction as possible when the joint moves.
Articular cartilage is made up of a dense network of cartilage cells and collagen fibers. It consists of around 80 % water. This gives the cartilage elasticity and gives it the function of a shock absorber that cushions every movement.
The alternation of loading and unloading of the joint is essential for supplying the cartilage with important nutrients. The movement of the joint pumps the nutrients into the cartilage. Physical exercise is therefore very important for the care and maintenance of joints.
Cartilage has no blood vessels - its ability to regenerate is correspondingly low. Once cartilage damage has occurred, it is therefore permanent, especially in adulthood. They usually lead to larger cartilage defects over time.
Left: Healthy cartilage, right: Rough, damaged cartilage © crevis | AdobeStock
The most common causes of cartilage diseases are directly linked to the musculoskeletal system:
The main causes of cartilage damage are wear and tear. With advancing age, the cartilage loses its elasticity - the water content of the cartilage body also decreases. The once smooth cartilage surface becomes rough and brittle.
Now the cartilage layers rub against each other with every movement of the joint. This loosens the smallest particles - the surface of the cartilage wears down and fine cracks appear.
fine cracks. This can ultimately lead to the complete destruction of the cartilage surface. Doctors summarize this mostly age-related cartilage degradation under the generic term osteoarthritis .
In addition to age-related joint wear and tear, accidents and sports injuries can also lead to cartilage damage. They must therefore be treated as quickly as possible to avoid causing permanent damage
Joint misalignments (e.g. knock knees and bow legs) are also associated with excessive strain on individual joint areas and cartilage surfaces. The wear and tear of the cartilage surface at the stressed areas is correspondingly severe.
Other reasons for cartilage damage are
Whether and when cartilage surgery is an option depends largely on the degree of cartilage damage. Doctors classify cartilage damage into four grades:
Grade 1 and 2 cartilage damage does not require cartilage surgery. Conservative therapies such as
are used to stabilize the cartilage damage.
The situation is different with grade 3 - 4, which involves deep cartilage damage that can usually be repaired by cartilage surgery.
Important prerequisite: the remaining cartilage substance and joint function are still well preserved.
As conventional X-rays only provide information when cartilage damage is already very advanced, magnetic resonance imaging(MRI) is the method of choice. An MRI makes even small cartilage defects visible and provides information about cartilage damage at an early stage.
Precise diagnosis is also possible with arthroscopy, i.e. a joint endoscopy .
Cartilage defects, among other things, can be easily detected using MRI © IEDNlab | AdobeStock
Various procedures are available for cartilage surgery. Which of these is used depends on individual circumstances such as
and the cause of the defect.
Microfracturing is one of the bone marrow stimulating procedures. This arthroscopic surgical method is used for minor cartilage damage.
It can already be used during an arthroscopy. If the doctor discovers corresponding cartilage damage, he immediately removes the damaged cartilage tissue and perforates the underlying bone several times.
The escaping fluid contains bone marrow stem cells that stimulate the growth of cartilage replacement tissue. The aim is to close the lesion again.
In this procedure, the doctor removes a type of bone cylinder with associated cartilage from the healthy part of the joint to be treated. He inserts the cut-out piece into the damaged cartilage area.
This allows new cartilage tissue to form over the defect.
This cartilage operation is suitable for minor but deeper cartilage damage.
Illustration of a cartilage transfer © giana | AdobeStock
In the case of major deep cartilage damage, the rather complex cartilage cell transplantation is promising.
The surgeon first removes a small piece of healthy cartilage during an arthroscopy. New cartilage tissue is created from this tiny piece of cartilage in a complicated procedure using special preparation in the laboratory.
This is then implanted into the damaged joint during a second operation.
The German Society for Orthopaedics and Trauma Surgery (DGOU) emphasizes the increasing importance of cartilage cell transplants and bone marrow stimulating procedures within cartilage surgery.
The DGOU has therefore set up a so-called cartilage register. It anonymously documents the recovery process of these procedures and thus provides important information for medical research.
If a misalignment of the leg axis is responsible for the cartilage damage, purely cartilage surgery is not sufficient. In this case, an additional corrective osteotomy is required before the actual cartilage surgery to correct the joint misalignment.
Cartilage surgery usually requires an inpatient hospital stay of 2-3 days. After discharge, the patient can expect a follow-up treatment phase, the content of which varies depending on the procedure performed.
In any case, a post-operative relief phase of around 6 weeks follows, during which the patient uses crutches. In order to restore the mobility of the treated joint, intensive physiotherapeutic mobilization is also required.
After knee cartilage surgery, the patient is usually given a motorized splint for exercises at home in order to get fit for everyday life as quickly as possible.
As a rule, the joint can be fully loaded again after around 3 months. Nevertheless, it is advisable to avoid sports that put a lot of strain on the joints in the first year.
Reconstructive procedures that restore destroyed or damaged cartilage are extremely complex. Cartilage surgery therefore places high demands on the surgeon and requires specialist knowledge and extensive experience.
You are in the best hands with a specialist in cartilage surgery.
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