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CARTILAGE TREATMENT

Causes of knee cartilage injury

Several mechanisms can cause cartilage damage in the knee joint. The best known cause is a fall on the knee (direct trauma), but over time, repeated microtrauma from overloading can have an equally devastating effect. Degeneration (age-related wear) is the most common cause of cartilage damage.

This last cause is also called osteoarthritis. As all protective layers of cartilage progressively disappear, the exposed bone is loaded directly, which in turn leads to bone marrow swelling (similar to "concrete rot" in buildings) and pain.

How can knee cartilage damage be treated?
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The treatment of cartilage injuries in the knee depends on the patient's age, the cause of the injuries and the precise location of the cartilage injury.

Limited injury in younger patients can be treated with biological or regenerative techniques. Above the age of 50, however, the results of cartilage treatment with biological techniques become more difficult to predict.

After thoroughly examining your personal situation, we examine which of the following solutions is most suitable for you:

1.

Obesity is the most important factor in the treatment of your cartilage injury that you can tackle yourself. If your BMI is over 30, discuss the situation with your GP. Weight loss can be the most effective way to prevent further cartilage damage in the knee.

2.

Some types of sport and exercise can be very beneficial for people suffering from cartilage injury in the knee. This is especially true for swimming, and most sports where the feet are fixed (do not move freely in space). During cycling, for example, the feet rest on the pedals while the front and rear thigh muscles move the knee. Impact sports, like running, and contact sports are very stressful for the knee and cartilage.

3.

Some dietary supplements are said to help prevent cartilage damage, although there is no independent scientific data to support this claim made mainly by the pharmaceutical and nutritional industries. Our advice is therefore: discuss the matter with your doctor and maybe test one of these nutritional supplements for a few months, after which you can evaluate (with a critical eye) whether it has made a difference for you.

4.

Medication for cartilage damage and arthrosis can only be taken after consulting your GP. Such medication is usually used in addition to a broader treatment schedule. In any case, avoid taking anti-inflammatory drugs (or NSAID) for longer than 14 days, as chronic use can be harmful to the stomach, kidneys and liver.

5.

There is a number of products that can be injected into the knee to relieve cartilage damage. A cortisone injection can treat an inflammatory reaction in the knee joint. However, we recommend you to limit yourself to two treatments per year. In addition to an increased risk of infection, cortisone can also be detrimental to healthy cartilage. Adverse side effects in the rest of the body are also possible, such as a rash in the face. If you have diabetes or kidney disease, cortisone treatment is not recommended.

6.

Injections with hyaluronic acid are often useful in the early stages of painful knee arthritis. Not only does it act as a "lubricant" for the knee joint, it is also a nutrient for the damaged cartilage. It can be safely injected during your consultation with Dr. Van den Wyngaert. The main advantage is that there are no side effects in the rest of the body, as opposed to a cortisone injection. Usually 2 to 3 injections are administered, with an interval of 3 to 6 weeks. Disadvantages are the cost (€70-80 per shot) and the limited success rate - we'd estimate a chance of success of about 6/10 over six months. Hyaluronic acid injections are not reimbursed by your health insurance. Some hospitalization insurance does provide a partial reimbursement.

7.

It is possible to inject the patient with centrifuged fractions of his or her own blood, also known as PRP (platelet rich plasma). The growth factors present within the platelets may have a healing effect on damaged cartilage. Usually three infiltrations are necessary. Disadvantages are the cost (approximately €200 per injection) and the need to have one's blood taken and manipulated. In addition, according to some scientific sources, long-term results could be rather limited.

Orthopedic surgeon - specialized in the treatment of knee injuries

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