Cartilage Injury Treatment

Dr. James - Orthopaedic Surgeon in Singapore

Written by Dr James Tan

Contents

    Cartilage acts as a cushion between bones at joints, allowing for smooth movement. When your cartilage is damaged, it can lead to pain, stiffness, swelling, and other symptoms. Cartilage injuries are common, especially knee cartilage injury is quite common among athletes.

    To help you treat cartilage injuries, let’s take an in-depth look at your cartilage cell biology, causes of cartilage damage, diagnosis, treatment options, recovery, and prevention strategies.

    Cartilage And Its Function In The Body

    Cartilage is a rubbery, flexible connective tissue that covers the ends of your bones where they meet to form joints. Its main role is to provide a smooth, gliding surface for joint motion and act as a shock absorber. The three main types of cartilage are articular (covers joint surfaces), fibrocartilage (forms meniscus in knees), and elastic (forms structures like the ears).

    Causes Of Cartilage Injuries

    Cartilage injuries have two main causes: traumatic injury and degeneration over time. Traumatic cartilage injuries often occur from sports, falls, twists, or direct blows to the joint. Gradual cartilage thinning happens through years of wear-and-tear, repetitive overuse, misaligned joints, or underlying conditions like arthritis. Genetics can also play a role in certain cases.

    How do I know if I have a cartilage injury?

    Symptoms of cartilage injuries include joint pain, swelling, stiffness, instability, locking, popping sounds, and limited range of motion. Pain is often worse with the use of the joint. Joint tenderness, a feeling that the knee or joint will “give out,” or a piece of loose cartilage in the joint are also potential signs.

    What are the different types of cartilage injuries?

    Major types of cartilage injuries are tears or defects in the articular cartilage lining the bone, damage to the fibrocartilage discs (like meniscus tears), and loose pieces of cartilage within the joint. Injuries are often categorised by severity based on size, depth, and location. Common sites are the knee, ankle, elbow, and shoulder.

    What is the difference between articular cartilage and meniscal cartilage injuries?

    Articular cartilage covers the bone surfaces, while the meniscus is fibrocartilage between the bones in joints like the knee. Articular cartilage has limited healing ability, while meniscus tears can sometimes heal with suturing.

    It is essential to keep in mind that both your articular cartilage and meniscal cartilage are prone to injury and degeneration. Regardless of what type of injury you are dealing with, it requires prompt professional medical treatment from an orthopaedic specialist.

    Treatment Options For Cartilage Injuries

    Treatment options for cartilage injuries depend on the individual case but may include rest, ice, medications, physical therapy, braces, injections, stem cell therapy, and surgery. An orthopaedic surgeon may recommend surgery for a cartilage injury. Surgeries like microfracture, osteochondral autograft, autologous chondrocyte implantation or scaffold implants aim to repair cartilage. A surgeon may opt for arthroscopic procedures which can remove loose pieces or smooth damaged areas.

    Rib Cage Cartilage Injury Treatment

    Treatment for a rib cage cartilage injury involves the following:

    • Resting and applying ice over the affected area several times a day
    • Taking non-steroidal anti-inflammatory medicines
    • Wearing a brace
    • Avoiding sports and activities that could aggravate the pain or injury
    • Sometimes, a plate may also be surgically placed in the ribs

    Articular cartilage injury treatment

    The treatment for articular cartilage injury knee involves:

    • Using the RICE protocol to manage pain and enhance strength.
    • Taking OTC NSAIDs or other painkillers
    • Avoiding sports and activities that further worsen the symptoms.
    • Corticosteroid injections
    • Wearing a brace
    • Surgery to repair the cartilage

    Elbow cartilage injury treatment and wrist cartilage injury treatment also involve similar measures and options.

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    Cartilage Injury Treatment in Singapore

    If you are dealing with a cartilage injury, don’t wait another day to get treatment! Delaying treatment can worsen symptoms or may lead to serious degenerative joint disease.

    Get started with the specialised care that you deserve to get on the path to a healthier life. For your personalised treatment plan, contact us online, email us at hello@quantumortho.com.sg, call us at +65 6235 8781, or connect with us on WhatsApp at +65 8028 4572. We also offer treatment for heel pain as well as back injury treatment.

    Locations

    Camden Medical

    1 Orchard Boulevard, #09-06

    Singapore 248649

    Mount Alvernia Hospital

    820 Thomson Road

    Medical Centre D #05-60

    Singapore 574623

    Book an Appointment

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    Treatment Process With Our Cartilage Injury Specialist

    Dr James Tan, our cartilage injury specialist at Ray of Health, deals with various orthopaedic conditions of the body. He advises his patients to consult him in case of any pain or injury at the earliest so that the condition can be assessed and diagnosed properly.

    1. Registration: First, register with Dr James' team and book an appointment here.
    2. First appointment: At the first appointment, Dr James Tan will carry out a thorough physical exam for your cartilage injury, and evaluate your medical history.
    3. Diagnosis: Typically, additional diagnostic tests are required to assess the causes of the problems accurately. This usually comes in the form of MRI or X-ray scans.
    4. Personalised Treatment Plan: Dr James will then create a personalised treatment plan based on your specific condition and needs, which could include undergoing surgery, and recommend the necessary treatment modalities to you.
    5. Follow-up sessions: Dr James will schedule additional follow-up sessions to monitor the recovery process until you fully recover.

    Disclaimer: Treatment plans may differ for different patients. Please contact Dr James for more information.

    dr james tan

    Accreditations

    1. Mount Elizabeth Orchard
    2. Mount Elizabeth Novena
    3. Farrer Park Hospital
    4. Mount Alvernia Hospital
    5. Aptus Surgery Centre
    6. Novaptus Surgery Centre

    Medisave & Insurance Shield Plan Approved

    If you are a Singaporean or a Permanent Resident of Singapore, some of our orthopaedic procedures can be claimed under Medisave. The claimable amount will vary based on the procedure's complexity.

    For other situations, please consult our friendly clinic staff regarding the use of your Integrated Shield Plan insurance.

    Personal Insurance

    1. Great Eastern
    2. Prudential
    3. HSBC Life

    Corporate Insurance

    1. MHC
    2. Fullerton
    3. Adept
    4. Alliance
    5. IHP
    6. iXchange
    7. Parkway Shenton
    8. Bupa
    9. Cigna

    Do all cartilage injuries require surgery?

    No, not all cartilage injuries need surgery. Mild injuries can improve with conservative treatments like rest, physical therapy, anti-inflammatory medication, and injections. However, significant or full-thickness cartilage defects that do not heal on their own often require surgery to stimulate cartilage regrowth or repair.

    What is the recovery process like after cartilage injury treatment?

    Recovery time varies based on the type of treatment. Minor injuries may heal in a few weeks. Major cartilage repair procedures require progressive rehabilitation over four to six months to slowly strengthen the joint and allow cartilage to integrate. Restrictions on bearing full weight or returning too quickly to activity should be strictly followed.

    How long does it take to recover?

    Mild cartilage injuries can heal within a few weeks up to two months. Recovering from major surgical treatments typically takes a minimum of four to six months. Full maturation and strengthening of cartilage after surgery can take over a year. Factors like location, size, and treatment method all impact overall recovery time. For example, articular cartilage injury recovery time after surgery is around 9 months, which in severe cases can take up to 18 months. A meniscus repair surgery can take around three to four months to recover. Rib cartilage injury recovery time is around 12 weeks or more.

    Are there any non-surgical treatments for cartilage injuries?

    Yes, treatments like rest, ice, compression, elevation, anti-inflammatory medication, braces, physical therapy, gel injections, steroid injections, viscosupplementation, prolotherapy, and PRP therapy can help manage cartilage injury symptoms non-surgically. However, none of these options are able to repair significant structural damage so these options may not be suitable in every case.

    Are there any alternative or experimental treatments for cartilage injuries?

    New treatments like Cartilage Autograft Implantation System (CAIS), DeNovo NT graft, and scaffolds with growth factors or stem cells show promise for cartilage repair. Oral glucosamine/chondroitin or injectable hyaluronic acid also aims to improve cartilage health. In addition to the promising treatments of today, more research is underway on cartilage regeneration techniques so we can expect to see some promising breakthroughs in the near future as well.

    Who is at high risk for cartilage injuries?

    While anyone can be affected by articular cartilage injury, some people are at a higher risk than others. Those who should be particularly cautious include people who have any of the following risk factors:

    • Age: Cartilage breaks down as people get older and that means that older adults are more susceptible to cartilage tears and injuries. In particular, athletes over the age of 40 have a higher risk than the rest of the population.
    • Sports: Athletes who play sports with frequent pivoting, twisting, and impact are more likely to deal with sports injuries and cartilage tears. This risk factor is especially true for anyone who plays sports like football, basketball, soccer, tennis, gymnastics, and hockey. The repetitive movements that these sports require can wear down cartilage over time.
    • Previous injury: People who have already had an injury or surgery are more likely to develop further cartilage damage. The existing damage makes the cartilage weaker and more vulnerable.
    • Obesity: Excess weight puts added stress and pressure on the joints, which increases your risk of cartilage degeneration and injury. While exercise is good for your overall health, the impact of physical activity is greater when you have more body weight.
    • Improper training: Athletes who do too much high-impact activity without building up gradually or without resting enough between sessions have a higher risk of overuse injuries like cartilage tears.
    • Anatomical factors: Some people are just built with increased susceptibility for cartilage damage due to the shape, alignment, or structure of their joints and bones. Unfortunately, this is one risk factor that simply can’t be helped.
    • Genetics: In addition to having certain unique physical traits, research has found that some people may be prone to cartilage degeneration based on their genetics and family history.

    Ultimately, the biggest factors are age, sports participation, previous injury, and obesity. Proper training and joint protection strategies can help reduce risk for athletes and active individuals but some baseline risk will always exist.

    Can I return to sports or physical activities after cartilage injury treatment?

    It is possible to return to sports after surgery, but high-impact activities may increase the recurrence risk as well as cause gradual wear. If you are an athlete, it is important to discuss your goals with your healthcare professional and ease back into your normal activities over many months as the joint gains its strength back. Certain key modifications like the use of braces and ongoing conditioning can be good tools to help you get back to your normal lifestyle.

    Are there any specific exercises or physical therapy for rehabilitation?

    Yes, physical therapy is vital after cartilage surgery, with gradual progression in weight bearing, range of motion, flexibility, strengthening, balance, and impact exercises. Gaining a solid level of muscle control around the joint prevents re-injury.

    Ultimately, maintaining your customised physical therapy is key as it will be focused on safely restoring your body’s function while avoiding over-stressing your healing cartilage.

    Frequently-Asked Questions About Cartilage Injury Treatment in Singapore

    Small partial-thickness cartilage defects may heal on their own over time, especially with rest and reduced joint stress. However, full-thickness defects or larger injuries that do not penetrate the bone rarely heal without intervention. Surgery is often needed to access the damaged area and stimulate cartilage regrowth in these cases.

    Disclaimer

    The information provided on this page is for educational purposes only and is not intended as a substitute for professional medical advice or treatment. Always consult your healthcare provider or specialist doctor regarding any medical condition that you might be facing and act on the doctor’s recommendations.

    References:

    1. Henning Madry, Ulrich Wolfgang Grün, and Gunnar Knutsen, "Cartilage Repair and Joint Preservation", National Library of Medicine, National Center for Biotechnology Information, 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3221423/
    2. Maryam Moradi, Farzad Parvizpour, Zohreh Arabpour, Nikan Zargarzadeh, Mahnaz Nazari, Heewa Rashnavadi, Farshid Sefat, Sanaz Dehghani, Marzieh Latifi, Arefeh Jafarian, "Articular Cartilage Injury; Current Status and Future Direction", National Library of Medicine, National Center for Biotechnology Information, 2024, https://pubmed.ncbi.nlm.nih.gov/37073663/
    3. "Cartilage damage", NI Direct Government Services, https://www.nidirect.gov.uk/conditions/cartilage-damage

    About The Author

    dr james tan

    Dr James Tan Chung Hui

    Dr James Tan is a skilled orthopaedic surgeon at Quantum Orthopaedics located at Camden Medical and Mount Alvernia Hospital, known for providing specialised medical services. Dr Tan has more than 10 years of experience in sports surgery and exercise medicine in Singapore. Apart from partnering with the industry to introduce various treatment techniques, Dr Tan has treated athletes from the Singapore National Teams and professional footballers from the Singapore Premier League and the Young Lions.

    Dr Tan specialises in treating sports injuries of the knee, shoulder and elbow joints, as well as cartilage and meniscus surgery. He is a member of the elite Asian Shoulder and Elbow Group and a founding member of the Singapore Shoulder and Elbow Surgery Society.

    Medical Education and Affiliations
    MBBS - National University of Singapore (NUS), Faculty of Medicine
    Member of the Royal College of Surgeons of Edinburgh (MRCS)
    MMed - Master of Medicine in Orthopaedic Surgery (NUS)
    Fellow of Royal College of Surgeons (Edinburgh)
    Adjunct Assistant Professor | NUS, LKC
    Senior Consultant Orthopaedic Surgery, Sports and Exercise Medicine
    Head of Department | Orthopaedic Surgery and Sports Medicine Centre
    Awards
    Principal Investigator of Tissue Engineering
    National Medical Research Council grants
    Collaboration with Scientists at NTU, TUM, A*Star, Osteopore & Trendlines Medical Singapore

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