center for orthopedic 
and sport injuries

 
 
 

Cartilage wear

Cartilage wear

Wear of the articular cartilage is undoubtedly the most common cause of joint pain in adulthood. The cause of development of wear is often not known, an important influence on its development have genetic factors as well as degenerative processes and overloading the joints. The development of cartilage wear usually progresses slowly, first  symptoms often  already appear at an early stage. This is mainly for the occasional pain that develop during long-term burdening on the affected joint.

Classical treatment of an early stage wear includes the prescription of NSAIDs (drugs that reduce pain),  periodical injections of corticosteroid preparations into the affected joint and reduces of activities that burden the injured joint. The problem of all these measures is that they focus only on reducing symptoms, but do not have any influence on the process of degeneration of cartilage.

Modern methods of treatment of cartilage wear attempt to influence the process of wear and thus work on the cause of problems itself, that leads to pain and joint swelling. These methods are particularly effective in the treatment of early and moderate forms of cartilage wear. It is important that you begin to use them early, when the first problem with the joint occurs. The aim of the early introduction of modern methods of treatment in joint wear, is slowed down process of wearing out the cartilage and prevention of the development of the final wear stage, that often requires the insertion of artificial joint.
In the center Artos
, we had specifically focused on the treatment of early forms of wear of the joints. It this, we use the methods presented below. Before starting any treatment, an orthopedic examination with clinical joint evaluation and digital X-ray diagnostics, is necessary. This is the basis for an expert evaluation of a suitable usage of any of the presented methods and for making a treatment plan.

 

Injections of hyaluronic acid

This is the most widespread modern therapies of articular wear. Hyaluronic acid is one of the major components of natural cartilage interstitial fluid, as such is therefore, a natural component of cartilage. With its injection into a joint, we attempt to fix its lack of cartilage, which is one of the first characteristics of the cartilage wear. This is a very viscous, clear liquid that improves the smoothness and mechanical qualities of worn cartilage and thus slows the progression of wear. The most commonly recommended treatment is five sequenced injection at intervals of one week, which is then repeated once or twice a year.

Injections of concentrated autologous platelet plasma - Orthokin®

Although our body contains substances that can cause certain diseases, it fortunately also contains substances that prevent diseases. As long as these substances are in equilibrium, we are healthy, but when there is an imbalance, out of any reason, signs of certain disease can appear.
In osteoarthritis, scientists have discovered the "bad" protein IL-1, which is a natural buffer against cartilage degradation, pain and inflammation. It is called interleukin-1 receptor antagonist (IL-1 Ra) and it is a so-called "good" protein that protects us from the degradation of cartilage and alleviates pain and inflammation in the joint.

The essence of the treatment of osteoarthritis with Orthokin ® method is that we obtain "good"proteins (IL-1-Ra) and other protective proteins from our own blood, and then we inject them into the diseased joint. Injected proteins are in this way completely natural.
Body's own proteins injected at higher concentrations are neutralizing "bad" proteins (IL-1). In this way we slow down the progression of osteoarthritis, reduce the pain, improve the mobility of the joint and prevent further degeneration of joint cartilage. Clinical studies have confirmed the efficiency and safety of the treatment with the Orthokin ® method. 
Treatment with inner articular injections of concentrated platelet-rich plasma begins by collection of your own blood. A special treatment of the collected blood follows. In this process, under sterile conditions, we eliminate platelet plasma and activate platelets to begin with the release of the protein IL-1 Ra. Then we deeply-freeze the mixed plasma and each time we the patient comes for application, we unfreeze it prior to the injection into the joint.

 

MBST - Cellular magnetic resonance therapy

The latest therapeutic method for treatment of osteoarthritis, overuse and degenerative changes of the soft tissues of joints and locomotor system, is the cellular magnetic resonance therapy. This is the method by which in a non-invasive way, with highly specific alternating electromagnetic field signals, we stimulate cell metabolism and thus improve the vitality of cells, and through this influence on tissue regeneration.
The method is successfully used to treat from early to moderate degenerative cartilage defects in osteoarthrosis of large and small joints, tendon problems, such as tennis elbow, chronic inflammation of the Achilles tendon, ligaments of patella, in heel spur and fascitis plantaris and also in chronic pain of the spine due to degenerative changes in intervertebral discs.

Irradiation with the alternating magnetic field in the cartilage accelerates metabolism of cartilage cells and stimulates synthesis of cartilage intercellular substance, and thus slows down the progression of cartilage wear and stimulates its recovery.

More info: http://www.mbst-therapy.co.uk/wp-content/uploads/2013/08/Medical-information.pdf

 

Arthroscopic cartilage microfracture

It is a minimally invasive surgery, which is usually performed on the knee. In procedure on a defective articular surface, we create microscopic cracks with special instruments. Through these cracks, it is possible for blood to break into the articular surface area, from the bones, under the damaged cartilage. With blood, damaged cells and proteins come in the area, which under the influence of local factors convert into connective cartilage. This tissue is, at least partly due to its characteristics, similar to hyaline cartilage, which covers a healthy joint, and replaces its function. Similar to other treatments, this method is also effective in small areas of cartilage defects, and when there are no significant changes in the bone surfaces. For the best possible result of the treatment, it is necessary that surgery is followed by an appropriate individual physical therapy. This is primarily to improve the extent of flexibility of the joint and to strengthen surrounding musculature, in the case of knee especially thigh muscles.

We usually recommend to patients to carry out one more cycle of MBST therapy in the postoperative rehabilitation, with the aim to extra stimulate maximized metabolic activity of the new cartilage cells.
In the advanced stage of disease, in some of the joints comes in consideration an arthroscopy with cleaning the affected joint. In the last stage of the articular wear, we normally use classical surgery with insertion of artificial joint.

 
 
 
 

How can we help you:

 
Artros, center for orthopedic and sports injuries Services: Common problems: Links:

Tehnološki park 21, Building D, 3. floor, 1000 Ljubljana

Telephone: 00386 1 518 70 63 and 00386 1 518 70 64

Fax: 00386 1 510 2342

E-mail: info@artros.si

 

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