How Does Osteoarthritis Develop and What Can You do to Treat It?

Cartilage is a tough, flexible connective tissue that isrelieve the symptoms of damaged articular cartilage.
found throughout the body. This rubbery tissue whichNonsurgical approaches include:
covers the ends of long bones functions mainly as a•Non-steroidal anti-inflammatory drugs (NSAIDS)
cushion for joints. It also, because it is covered by ahelp with pain and inflammation. They do have
thin layer of lubricating material called "synovial fluid"potential side effects that require close monitoring.
also acts to allow gliding of joints.Osteoarthritis is a•Physical therapy. Various types of treatments
disease of cartilage. The cartilage becomes damagedsuch as electrical stimulation, diathermy, and
and begins to wear away.ultrasound,can reduce pain. And exercises which
Cartilage does not have a blood or nerve supply... Asstrengthen the muscles supporting the joint may help
a result, unlike damaged skin or muscles or otherto reduce the pressure on the joint, and reduce pain.
organ systems that can heal, damaged cartilage early•Assistive devices. Canes, walkers, and braces are
on does not cause pain and will not heal quickly.sometimes useful.
There are three types of cartilage:•Lifestyle changes. Weight reduction, regular
•Elastic cartilage is a pliable form of cartilage foundexercise, and so on can be useful.
in structures such as the outside of the ears, nose,•Corticosteroid injections can reduce pain and
and epiglottis.swelling temporarily but should not be given in the
•Fibrocartilage is a tough type of cartilage and issame joint more than 3 times per year.
very shock resistant. It is found in the discs that•Viscosupplments are special lubricants that may
form part of the spinal column and also is the type ofdramatically improve pain and mobility when injected
cartilage that makes up the meniscus (ring of cushioninto a joint. It is strongly recommended that steroid
material) located in the knees, hips, and shoulders.and viscosupplement injections be given using
•Hyaline cartilage is a softer type of cartilage thatultrasound guidance to ensure proper placement of
is found most commonly in joints.injections.
Cartilage damage is not painful early on, since noWhen non-surgical approaches aren't enough, then
nerve fibers are present. However, as the problemsurgical treatments may be required.
progresses and develops into arthritis, there areArthroscopic lavage and debridement employs an
symptoms which do occur.arthroscope to wash the joint out. The technique
Symptoms of articular cartilage damage include:cannot repair the damaged cartilage, but it can help
•decreased range of movement in the affectedto reduce the pain and increase mobility.
jointMicrofracture surgery: This is a procedure that
•joint paininvolves drilling tiny holes (micro fractures) into the
•stiffness with inactivitybone underneath the damaged cartilage. This
•swellingexposes the blood vessels inside the bone. Blood cells
If the damage is particularly severe, a piece ofthen begin to stimulate the production of new
cartilage can break off and become loose. In thiscartilage. The disadvantage is that the newly formed
case, the loose piece of cartilage may affect thecartilage is fibrocartilage rather than hyaline cartilage.
movement of the joint. This can cause a feeling ofFibrocartilage is not as strong as hyaline cartilage.
'locking' or catching. Sometimes, the joint may alsoTherefore, it can wear away more quickly than
give way.hyaline cartilage.
Articular cartilage damage can occur as a result ofMosaicplasty: This is a technique that involves
trauma- a direct blow to the cartilage. This is whyremoving healthy cartilage from the non-weight
cartilage damage is often a problem for people whobearing areas of a join and using it to replace
play contact sports.damaged cartilage.
Cartilage can also become damaged gradually, overAutologous chondrocyte implantation (ACI) : This is a
time. There is an increased risk of developing thistechnique where a small sample of cartilage cells is
type of cartilage damage for heavy individuals, or fortaken from the non-weight-bearing part of the knee.
people with an anatomic abnormality which causes aThe cells are sent to a laboratory where they are
structural problem with the joint.stimulated to divide and produce new cells. After a
Interestingly enough, immobility can also damage thefew weeks, the number of cartilage cells will have
cartilage.increased by about 50-100 times from their original
The major problem when damage occurs to cartilagenumber. The new cartilage cells will then be placed
is that articular cartilage has a very limited capacityunder a flap of material that is sewn over the
for self repair. A small amount of damage does notdamaged part of the joint.
repair itself and often gets worse over time.For patients where cartilage has worn away
The diagnosis of cartilage damage can be suspectedcompletely, total joint replacement is probably the
by a careful history and physical examination.procedure of choice. While it is successful for most
Confirmation can be obtained by diagnostic studiespeople, there are potential complications such as
such as:infection, blood clots, and prosthesis failure which can
• Magnetic resonance imaging (MRI): MRI scans useoccur.
strong magnetic fields to produce detailed images ofThere are a number of research projects that are
the inside of the body. It can often detect cartilagecurrently investigating additional efficient and
damage.effective ways of repairing cartilage.
•Diagnostic ultrasound: This relatively new method•Hybrid cartilage is an investigational procedure
of musculoskeletal diagnosis uses sound waves towhere human cartilage cells are combined with
image cartilage and inflammation.synthetic fibers to form a patch.
•Arthroscopy: This is a form of surgery where an•Stem cells: Another area of research is looking at
arthroscope- a small telescope is used to look insideways of using special cells, known as stem cells, to
the joint.generate new cartilage. This latter procedure is
•X-ray: While this is the traditional method ofpromising. Unfortunately, only a few centers
imaging, the drawback is that osteoarthritis has to beworldwide have the knowledge and expertise to
relatively severe before it shows up on x-ray.perform this procedure properly.
There are a number of treatments that can help to