Cartilage loss or Cartilage tear if restricted a particular area and is a localized problem, then it can be treated effectively. If the cartilage loss is generalized and if the whole joint is involved that is called arthritis and the treatment modalities involved are different.

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Diagnosis

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X-ray. X-rays may show the cartilage loss only when the cartilage loss is in large areas, however it is not reliable diagnostic tool for assessing the cartilage loss. 

MRI Scan. MRI Scan is a useful mode of investigation to assess the extent and depth of the cartilage loss. It also helps in assessing the condition of the rest of the joint structures such and ligaments and menisci as well as to check for loose bodies if any.

Cartilage Mapping. This is a more advanced tool in MRI that helps to assess the cartilage loss in a better way with more clarity than the MRI scan alone. 

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Treatment

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For a contained defect (loss of cartilage in a specific area but intact cartilage all around) chondroplasty is the best option of treatment. It is done by arthroscopy (Keyhole surgery). 

There are various types of chondroplasty. Depending on the nature and extent of the defect and the condition of the rest of the joint, the decision would be made regarding the best option for that particular cartilage defect for that particular patient.

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Abrasion chondroplasty

 

For the areas of cartilage loss, small holes are made into the bone. These are called microfractures. Bleeding into these holes helps in bringing the stem cells to this area for heping to grow new cartilage which is called fibro- cartilage. 

 

Autocart Chondroplasty

 

This is a German technology by Arthrex in which the bone shavings are taken from the edges of the joint where there is no weight bearing. This mince is mixed with thrombin solution and PRP. This paste is applied to the area of cartilage loss. This helps to form a new cartilage in that particular area. 

 

Regrow Chondroplasty – Stem Cell Therapy 

 

Cartilage sample is taken from the small non weight bearing area and sent to lab. 4-5 weeks later a second procedure is undertaken where the stem cells are injected to the area of cartilage loss to form the new cartilage. 

 

Rehabilitation

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Post chondroplasty, loading the graft area is avoided for first 3 weeks. However early mobilisation with CPM (continuous passive motion) machine or gentle passive stretches is recommended.  

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