Cartilage damage in the knee

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The thinning of the cartilage covering the bones, or its complete destruction over time, causes the bones to rub against each other. Due to this friction, the bones wear out over time and this causes pain.

There are three types of cartilage in our body: articular and hyaline (the tissue that covers the joints), fibrous cartilage (miniscus), and elastic cartilage (found in the ear). Each cartilage type has its own specific structures. Hyaline cartilage does not have a vascular system and therefore cannot renew itself. Hyaline cartilage is composed of chondrocyte cells.

Cartilage prevents friction in the joints and also absorbs shock.

The cartilage scaffold is made up of collagen and proteoglycans and is highly organized. 65-80% of cartilage consists of water.

The thinning of the cartilage covering the bones, or its complete destruction over time, causes the bones to rub against each other. Due to this friction, the bones wear out over time and this causes pain. Cartilage is found between bones, nose, ear, ribs, knees, elbows, wrists, spine, hips. It has a softer texture than bone, but is harder and less volatile than muscle.

Today, most cartilage diseases are encountered in the knee. In addition, cartilage deformation is seen in the hip bone in advancing ages.

Why?

As a result of trauma, falls, traumatic sports accidents, cartilage diseases occur due to wear over time.

What are the symptoms?

Patients usually have swelling and pain in the joint. Depending on the degree of pain, the patient may not be able to continue the activity. If there is a mechanical degeneration, the patient feels stiffness, strain, swelling and pain in the joint.

Treatments

When is surgery necessary?

When the body is damaged, enzymes are secreted and these enzymes can further damage the damaged tissue. If the damage to the cartilage has not affected the bone, the cartilage cannot heal on its own. In traumas in which the bone is affected, the replaced cartilage sometimes cannot fulfill its former functions. Damages smaller than 2 cm have the capacity to heal.

In this type of damage, arthroscopy can be applied. Arthroscopy pierces the bone, accelerating the blood flow and accelerating the healing process. Smaller injuries are asymptomatic, so surgery is not required.

In larger damage, cartilage transplantation may be required. In osteoarthritis patients, physical therapy, changing their lifestyle, oral or local injection drugs are recommended to patients other than surgery. In very advanced cases, prosthesis is recommended. Tibia or femoral osteotomy (operation to cut the bone at the joint) can reduce symptoms and delay total joint replacement surgery.

Surgical Results:

arthroscopy With the help of the camera inserted into the joint area, that area is examined. In this way, surgical intervention is also easily performed.

Arthroscopy microfractureWith this technique, pseudo-cartilage is created with this camera method.

Autologous chondrocyte implantation

This technique consists of two stages. First of all, healthy cartilage tissue is obtained from the patient. This stage is carried out by means of arthroscopy. In the laboratory, chondrocytes in the tissue taken later are multiplied.

When chondrocytes are ready, they are surgically placed. This technique is suitable for young patients and single injuries smaller than 2 cm.

Carticel (Genzyme), the only FDA-approved cellular therapy application, is suitable for those who cannot recover with other treatment methods.

Osteochondral autograft transplantation

With this technique, cartilage is transferred from one part of the knee to another part.

Osteochondral allograft transplantation

If the cartilage damage is too great and the cartilage cannot be removed in another region, the required tissue is taken from a cadaver. Sterilized in the laboratory and prepared for transport. Allograft is larger than autograft.

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