Cartridge Surgery

Cartridge Surgery; The articular cartilage is the tissue covering the bone ends, providing the smooth, sliding structure of the surfaces forming the joint, allowing the joint surfaces to move freely over each other.

Thanks to the cartilage surface, pressure is distributed, and friction force is minimized. Initially, no pain is felt in articular cartilage damage. This is due to the absence of nerve endings in the cartilage tissue.

In cases where the joint cartilage damage is severe and large and the bone underneath is exposed, then pain is felt. Cartilage damage level,

• Stage 1:Softening of cartilage
• Stage 2:Superficial cracks in cartilage
• Stage 3:Deep cartilage damage

Craters are the stage in which the underlying bone is exposed, during this last stage, the unbound cartilage fragments can fall into the joint and move freely, trapping the joint, causing pain and cartilage erosion.

With radiographic and MR examinations of patients with suspected joint cartilage lesions, the location and level of the lesion are determined.
Local cartilage tissue loss is a common condition.

Although it is due to many reasons, the most common reason is trauma. This can also be a major trauma or a recurrent minor trauma.

Cartilage problems are frequently observed in young patients with knee sprains or direct traumas to knees during arthroscopic surgery. Severe level of sports activity and cartilage defect in other family members can be considered as possible causes.

Besides that, traffic accidents and knee sprains in elderly patients with impaired cartilage can also cause cartilage damage. Moreover, cartilage problems are observed in patients with impaired joint surface load distribution due to mechanical disorders of the knee in cases where bone feeding under cartilage is impaired.

The most important problem in joint cartilage damages is that there is no vascular structure to which cartilage is fed and it is fed only with the aid of synovial fluid. The joint cartilage cannot renew itself when damaged. Joint cartilage consists of the type of cartilage that is called hyaline cartilage.

In the event of a damage, a type of cartilage that is called fibrocartilage is formed in the inner part of the joint, however, this type of cartilage has not hyaline cartilage properties. The treatment is planned according to the size, severity and causes of cartilage damage.

Exercise and cartilage supporting drugs may be enough for mild cartilage damage. In case there is a condition that causes cartilage damage, it should be removed first of all.

For example, if problems such as present meniscus rupture, intra-knee free matters, and kneecap issues have caused cartilage damage, these primary problems are treated by arthroscopic surgery primarily.

Exercise and oral cartilage support drugs are recommended in grade 1-2 patients and intra-articular viscosuplement injections and physical therapy are applied in early stage lesions.

In the lesions where the bone is exposed that we called Grade 4, the edges of the region with cartilage damage are treated with arthroscopy at first. Knee arthroscopy is applied with the method that we called micro-fractures in bone exposed from under cartilage in patients under 30 years of age. It is usually applied in areas under 2cm².

Besides that, the damaged areas in the load-bearing parts are repaired with hyaline cartilage by applying cartilage bone cylinders taken from intact sections of the knee by the method that is called mosaicplasty.

In this method become popular recently, intact cartilages taken from the knee joint by arthroscopic surgery are reproduced with cartilage cell cultures in average 6 weeks and applied to cartilage loss area with a second operation.

Cartilage does not have the ability to repair itself. Consequently, knee pain, limitation of movement, swelling, locking of joints may be observed. The cartilage defect should be distinguished from calcification, which is the general loss of cartilage in the knee.

The loss of cartilage in the cartilage defect is in a certain region and cartilages in other regions are normal. However, untreated cartilage defects may cause extensive calcification of the knee joint over time when they are not treated.