Written by Dr Gowreeson Thevendran, MBChB (Bristol), MRCS.Ed, Dip. Sports Med.Ed, FRCS.Ed (Trauma & Ortho. ), FAMS (Singapore)
What is a Cartilage Injury?
Cartilage is a flexible connective tissue that covers the surface of bones at the joints. A cartilage injury occurs when there is damage or trauma to the cartilage tissue, which can cause pain, swelling, and limited mobility. These injuries to the cartilage can occur due to a variety of reasons, such as sports injuries, and can also be caused by wear and tear over time.
The most common types of cartilage injuries include tears or fractures in the cartilage, which can result in pieces of cartilage becoming loose in the joint. In severe cases, the injury can cause the bone underneath the cartilage to become damaged as well.
Symptoms of Cartilage Injury
When the cartilage is damaged, you may experience a range of symptoms depending on the severity and location of the injury. Common indicators may include:
- Persistent joint pain
- Stiffness, especially after periods of inactivity
- Noticeable decrease in joint mobility
- Grinding sensation when moving the joint
- Swelling in the surrounding area
These symptoms warrant a professional evaluation to determine the extent of the injury and the most appropriate course of action.
Diagnosing Cartilage Injury
Diagnosing a cartilage injury requires a thorough evaluation of the joint and surrounding tissues by a qualified healthcare provider, such as a cartilage specialist. The specialist may begin with a physical examination to assess the joint for pain, swelling, and limited mobility.
Imaging studies, such as weight-bearing X-rays and MRI scans, may also be ordered to assess the extent of the damage to the articular cartilage and identify any associated bone damage as well as surrounding tissues and ligaments. In some cases, the specialist may also perform arthroscopy to visualise the damage and potentially repair the cartilage.
Non-surgical Cartilage Injury Treatment
The type of treatment recommended for a cartilage injury depends on several factors, including the extent of the damage, the patient's age and overall health, and activity level. Treatment options may include rest, ice, and physical therapy to help manage pain and improve mobility.
In severe cases, surgery may be necessary to help repair or remove damaged cartilage or bone. Cartilage repair treatments, such as cartilage regeneration or transplantation, may also be recommended to help restore function to the joint and prevent further damage. A cartilage specialist can recommend a suitable treatment based on the patient's specific needs and goals for recovery.
Cartilage Repair
When non-surgical treatments are insufficient, surgical options are considered. The choice of procedure depends on factors like the injury's location, size, depth, and the patient's age, activity level, and overall health. Cartilage repair can take several forms:
- Arthroscopic Surgery: This is a common approach to knee replacement surgeries. It involves the use of a small camera, inserted through tiny incisions, to help the surgeon visualise the joint and guide the surgical instruments.
- Microfracture Surgery: This method involves drilling small holes in the bone beneath the damaged cartilage to stimulate new growth.
- Cartilage Transplantation: This approach involves replacing the damaged cartilage with healthy tissue from another area of the patient's body or a donor.
Cartilage Regeneration
Cartilage regeneration is another method that focuses on the potential of restoring damaged cartilage to its natural state. This may involve:
- Stimulating the body's healing processes
- Using stem cell therapy and growth factors
The specific approach typically depends on the individual's condition, but the aim is to achieve optimal pain relief and better joint function, helping patients return to their preferred activities with minimal limitations.
Cartilage Treatment
Aside from the treatment options above, the doctor may recommend any of the following methods:
- Lavage and Debridement: This procedure helps clean the joint and removes loose or damaged tissue to improve joint function.
- Marrow Stimulation (Microfracture): Tiny fractures are made in the underlying bone to help stimulate new cartilage growth.
- Mosaicplasty: Healthy cartilage is taken from one area and transplanted to the damaged area.
- Osteotomy: The bone beneath the damaged cartilage is realigned to help relieve stress on the cartilage.
- Allograft Osteochondral Transplantation (AOT) and Autologous Chondrocyte Implantation (ACI): These approaches involve transplanting healthy cartilage to the affected area, either from a donor (AOT) or from the patient's own cells (ACI).
- Artificial Scaffolds: Synthetic materials are used to support the growth of new cartilage.
Recovery Period for Cartilage Surgery
Recovery from cartilage surgery may vary based on the type of procedure performed, the extent of the injury, and the patient's overall health. A personalised recovery plan, including physical therapy, gradual return to activities, and regular follow-up appointments, is often necessary for an optimal outcome. Patients are encouraged to adhere to their recovery plan and maintain open communication with their healthcare team throughout the process.
Dr Gowreeson Thevendran
MBChB (Bristol), MRCS.Ed, Dip. Sports Med.Ed, FRCS.Ed ( Trauma & Ortho. ), FAMS (Singapore)
Dr Gowreeson Thevendran is an orthopaedic surgeon in Singapore who specialises in lower limb orthopaedic conditions, trauma, and fracture surgeries of both the upper and lower limbs. He received his medical education from the University of Bristol and completed his surgical training in the UK and Canada. Before establishing his private practice, he served as Chief of Foot & Ankle Surgery, Department of Orthopaedics at Tan Tock Seng Hospital, Singapore.
Dr Gowreeson Thevendran’s Qualifications and Awards:
- Bachelor of Medicine and Surgery, University of Bristol, England
- Fellow of the Royal College of Surgeons, Edinburgh
- Diplomate Faculty of Sports and Exercise Medicine, Royal College of Surgeons Edinburgh
- Fellow of the Academy of Medicine, Singapore
- SICOT PIONEER Founders Award 2020
- 2015 European Foot & Ankle Society ‘Best Podium Presentation’ Award
- 2013 Singapore Orthopaedic Association Junior Travelling Fellowship
- 2012 NHG Critical Talent Special Recognition Award
- 1998 Enid Lindt Prize in Clinical Surgery
- 1995 Public Services Department Full Medical Scholarship
Languages Spoken:
- English, Malay, Tamil
Frequently Asked Questions About Cartilage Repair & Regeneration in Singapore
Clinic Location
OrthofootMD@Novena
- Mount Elizabeth Novena
38 Irrawaddy Road #05-42 Mount Elizabeth Novena Specialist Centre Singapore 329563
OrthofootMD@Mount Alvernia Hospital
- (Mount Alvernia Hospital)
820 Thomson Road #01-01/02 Mount Alvernia Medical Centre A Singapore 574623
Dr Gowreeson Thevendran is currently an orthopaedic surgeon with Island Orthopaedic, a one-stop care centre for orthopaedic health under Healthway Medical Group. He specialises in treating lower limb orthopaedic conditions, as well as trauma and fracture surgery of both the upper and lower limbs. Prior to establishing his private practice, Dr Gowreeson was Chief of Foot & Ankle Surgery at the Department of Orthopaedics at Tan Tock Seng Hospital (TTSH). Today, he continues to serve the Orthopaedic Department at TTSH as a visiting consultant.