Anyone with a cartilage joint injury knows how crucial it is to restore mobility. Here, orthopaedic surgeon DR FRANCIS WONG talks cartilage repair, the causes of cartilage damage and the treatments of these injuries, and he gives an insight into the future of the field.
What are the most common causes of cartilage damage in joints, and who is most at risk?
For young, active patients in their 20s to 30s, the cartilage status of the knee is generally healthy, and the cartilage is sturdy enough to withstand repetitive stresses. The common causes of damage are traumatic sports injuries, such as a direct fall on their knees during a rugby tackle, or an awkward landing during a basketball jump.
For patients in their 40s or early 50s, their cartilage has been through some wear and tear, so is more susceptible to cracks and subsequent cartilage damage. Common causes are repetitive injuries, such as a strained knee from running, jumping or lunges.
How do untreated cartilage damage or injuries affect joint health over time?
They can worsen the health of the knee in two major ways:
- The cartilage damage and the underlying exposed bone signals an inflammatory response to the rest of the knee, which affects the surrounding cartilage. This response softens and weakens surrounding healthy cartilage, creating a vicious cycle of more damage.
- Loose cartilage pieces from cartilage injuries can roam around the knee and create a “stone in the cogwheel”, jamming the otherwise normal functioning knee, causing a painful locking phenomenon. The smooth lining of the cartilage can also be further scratched by these loose cartilage pieces, kickstarting damage to healthy cartilage from what we call “third body wear”.
Tell us about the newest treatment options for cartilage damage.
Cartilage resurfacing techniques, where an orthopaedic surgeon patches up the cartilage “hole” to stop further damage, have improved with newer implants and better surgical techniques to ensure good outcomes. Orthobiologics, using biological treatments such as your own body’s tissues and cells to heal your cartilage injuries, are also changing the way we treat cartilage injuries.
Injections with stem cells and stem cell derivatives, such as exosomes, have also made significant progress in the field of regenerative medicine. While they’re still in the experimental phase, we’ll be seeing these treatments become routine clinical practice soon.
Can lifestyle changes or rehabilitation help prevent further cartilage damage?
A big “Yes”! The problem with most of us is that, while we understand the need to exercise and engage in sports, we neglect the most important fact: that our joints need to be conditioned and trained in order to perform the sport that we love.
I highly recommend consulting your doctor first to assess your musculoskeletal health and advise on initial conditioning exercises before starting your chosen sport.
What excites you about the future of cartilage repair?
The fact that we are edging close to joint preservation ‘nirvana’, where we can keep your joints healthy for your entire lifetime, is such an exciting time for cartilage surgeons like myself. I always tell my patients, ‘You do what you need to do, and I’ll help you get there to the best of my ability’. My job allows me to communicate with my patients deeply, and provide them with solutions to maintain their quality of life. It’s such a blessing and privilege to be able to do that.
About the doctor
Dr Francis Wong is a consultant orthopaedic surgeon with over 16 years’ experience, specialising in joint preservation, cartilage repair and orthopaedic regenerative medicine.
Island Orthopaedics
Mount Elizabeth Novena Specialist Centre; Mount Alvernia Medical Centre; Gleneagles Hospital
6356 0588 | iog.com.sg
This article on cartilage damage in joints first appeared in the February 2025 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy!
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