Cartilage is a smooth, flexible tissue that lines the ends of bones within our joints. It acts as both a cushion and a shock absorber, allowing bones to glide over one another with ease while protecting the joint from excessive wear. Unlike many other tissues in the body, cartilage has a very limited blood supply, which means its ability to repair itself after injury is poor.

When cartilage becomes damaged, either through trauma, overuse or gradual degeneration, the joint may lose its natural protection. Some of the common locations include the knee, ankle, shoulder, elbow and hips. This often results in pain, stiffness, swelling and a gradual decline in mobility if it is not treated early.

What are the different types of Cartilage Injuries?

Cartilage injury can vary widely in both form and severity. They often involve damage to the smooth, protective surface that lines the ends of bones or to the specialised fibrocartilage structures within the joints, such as the meniscus in the knee.

Due to the fact that cartilage does not heal easily, even small defects can progress over time. Some of the common types of cartilage injuries are:

• Articular cartilage defects – these are cracks, softening or worn patches on the smooth cartilage covering the ends of bones. They can result from direct trauma, repetitive stress, or gradual degeneration.
• Meniscus injuries – although technically fibrocartilage, meniscus tears are a frequent form of cartilage damage in the knee. They usually occur during twisting or pivoting movements.
• Osteochondral injuries – this refers to damage that affects both the cartilage and the underlying bone, often from impact or sports injuries.
• Loose bodies – fragments of cartilage that break off and float within the joint, leading to catching, locking or pain.

What causes Cartilage Injury?

The cartilage can be damaged in several ways. But the mechanism of injury often explains how symptoms develop. This includes:

• Degeneration – as we age, cartilage loses elasticity and its ability to regenerate. Every day use then slowly erodes the smooth surface, leading to thinning and fraying. 
• Repetitive stress – joints that are placed under continuous strain, for example running, squatting or heavy lifting, may develop micro-injuries over time. These repeated stresses gradually wear down the cartilage and reduce its resilience.
• Trauma – a sudden impact, such as a fall, direct blow or sports collision, can cause cracks, tears or pieces of cartilage to break loose within the joint. This is common in athletes or individuals who sustain acute injuries.
• Underlying joint conditions – diseases such as osteoarthritis or inflammatory disorders accelerate the breakdown of cartilage, making it more prone to injury even with minor activity.

What are the symptoms of Cartilage Injury?

Cartilage damage may begin subtly but often worsens over time. Some of the signs are:

• Clicking or grinding – a sensation of catching or noise when mobbing
• Instability – the joint may feel weak or unreliable, especially if the injury is extensive
• Pain – discomfort that is sharp during movement or persistent at rest
• Stiffness – reduced ability to fully bend or straighten the joint
• Swelling – inflammation in the joint, particularly after activity

Who is at risk of Cartilage Injury?

Although cartilage injuries can affect anyone, there are certain groups who are more susceptible to developing the injuries. Some of them are:

• Age – with age, cartilage naturally becomes thinner and loses its regenerative properties. Even normal daily activities can then lead to wear and tear.
• Family history – some individuals may inherit weaker joint structures or be predisposed to conditions like early osteoarthritis, which raises the risk of cartilage damage.
• Athletes – sports involving sudden twists, impacts or repetitive stress, such as football, basketball and running, place significant pressure on cartilage and increase the likelihood of damage.
• Prior injuries – past injuries, such as ligament tears or fractures, disrupt the joint’s mechanics and stability, gradually eroding the protective cartilage.
• Occupational exposure – jobs that require repetitive kneeling, squatting or heavy lifting subject joints to constant load, gradually eroding the protective cartilage.
• Obesity – carrying extra weight places greater pressure on weight-bearing joints such as the knees and hips, increasing the strain on cartilage surfaces.

What are the complications of untreated Cartilage Injury?

If treatment is delayed, cartilage damage often worsens, as the tissue does not heal on its own. The joint may become progressively stiffer and more painful, limiting daily function. Gradually, the uneven surfaces created by damaged cartilage can lead to accelerated joint wear, instability and loss of motion.

One of the most significant long-term consequences is the development of osteoarthritis, where the protective cartilage wears away almost completely, leaving bone rubbing against bone.

How is Cartilage Injury diagnosed in Singapore?

An accurate diagnosis is essential to determine the extent of damage and guide the right treatment Plan. With Dr James Tan, the diagnostic procedure typically involves:

• Medical history – the specialist begins by discussing the patient’s symptoms, when they started and whether there was an injury or repetitive strain that triggered the pain. Any history of previous joint problems will also be reviewed.
• Physical examination – the joint is assessed for swelling, tenderness and stability and range of motion. Some specific movements may be performed to reproduce the pain or identify stiffness.
• Imaging tests – X-rays can help exclude bone problems. Meanwhile, a magnetic resonance imaging (MRI) scan is most effective for visualising cartilage. This provides a detailed picture of the soft tissue, allowing doctors to see the extent of damage and whether other structures, such as ligaments or meniscus, are affected.
• Arthroscopy – this is a minimally invasive procedure, using a small camera, which is carried out to enable doctors to directly inspect the joint and confirm the diagnosis.

How is a Cartilage Injury treated in Singapore?

The treatment often depends on the severity of the damage, as well as the patient’s age, lifestyle and activity goals. However, the primary goal is to relieve pain, restore function and slow further joint deterioration, which may involve:

Conservative management

For mild injuries, rest and activity modifications are often the first steps. The RICE protocol, which entails Rest, Ice, Compression and Elevation, helps reduce inflammation. Meanwhile, braces or walking aids may be recommended to ease strain on the affected joint.

Non-surgical options

Medications such as non-steroidal drugs (NSAIDs) help reduce pain and swelling. Injections may also be considered, such as:

• Corticosteroids – provides short-term relief from inflammation
• Platelet-rich plasma (PRP) – promotes healing and supports tissue repair

Surgical treatment

When cartilage damage is significant, surgery may be required to restore joint function:

• Arthroscopic debridement – smoothing rough cartilage edges to reduce irritation
• Microfracture surgery – creating small holes in the underlying bone to stimulate new cartilage growth
• Cartilage transplantation – transferring healthy cartilage from another part of the joint or using grafts to restore the surface

Rehabilitation

Physiotherapy is an integral part of recovery, whether treatment is conservative or surgical. A tailored rehabilitation plan helps strengthen muscles, restore range of motion and gradually reintroduce weight-bearing activities.

Summary

Cartilage injuries may start with mild discomfort but can progress into long-term joint problems if treatment is delayed. With early diagnosis and the right treatment, it is possible to relieve symptoms, restore movement and protect the joint from further damage.

If you are experiencing persistent joint pain or stiffness that may be related to cartilage damage, we encourage you to schedule an appointment with Dr James Tan. By seeking early intervention, our doctor can help preserve your joint health and keep you moving comfortably for years to come.