Arthroscopic picture of the articular cartilage of a patella (knee cap) with roughening and irregularity of the surface
Same patella after arthroscopic chondroplasty (smoothening of the cartilage)
Articular cartilage is an extremely important component of joints. It is the smooth covering of the end of the bones that allows for frictionless gliding of one bone against another. Most people are probably most familiar with the articular cartilage on the end of a chicken drumstick.
Wearing away of this cartilage or damage by injury causes the joint surface to become rough and irregular leading to friction. This roughening of the articular cartilage is referred to as chondromalacia, which can be painful. This leads to further wear and tear and inflammation and eventually results in the most common type of arthritis, osteoarthritis (also known as degenerative joint disease).
Unfortunately, articular cartilage in adults has extremely poor ability to heal after injury. A lot of research is being done to find a way to stimulate the repair of articular cartilage with medications, injections, open surgery, or arthroscopic procedures. All have met with limited success. Although we do not have a perfect solution to this problem, many new promising techniques are currently available. Unfortunately, each technique has limitations and is indicated for only specific types of problems. Only a surgeon experienced and skilled in various different techniques to address injury to the articular cartilage can give you an accurate assessment of options for treating a particular joint.
If the entire joint’s articular cartilage is worn, the only procedure expected to give lasting pain relief with good joint function is a total joint replacement. However, these artificial joints themselves wear out with time and use. Consequently, a young adult or middle-aged person should try to postpone this surgery for as long as possible due to the fact that they tend to be more active than older individuals and consequently the artificial joint wears out more quickly. Furthermore, results of revision artificial joint surgeries are generally not as good as those of the first-time implantation.
