Damage may also be the result of a direct blow to the knee. When these symptoms dont go away after a few days, you set up a doctors appointment. KneeAnkle Articular Cartilage Repair Moving bones along a tough, damaged joint surface is difficult and causes pain. Should you have surgery for a small area of cartilage damage? joint laxity. 900 Round Valley Drive, Suite 100
WebSymptoms. Chondral injuries of the knee are lesions of the articular cartilage of the knee joint. The cartilage can be damaged when the knee pivots or twists suddenly for example during sport, or by a direct blow to the knee. Grade I is the mildest and grade IV is the most severe describing full thickness injury of the cartilage. Pain with prolonged walking or climbing stairs can occur. Webknee arthroscopies over a 4-year period, Curl and associates noted articular damage in 63% of the patients, with over 60% of these having a grade III or grade IV chondral lesion.3 The natural history of chondral injury is not well defined, but once patients become symptomatic from these lesions, progression is likely. In many cases, the damage is limited to the thin layer of articular cartilage at the end of a bone, which is referred WebChondral lesions may be degenerative (a "wear and tear" problem) or traumatic (caused by an injury such as falling on the knee, jumping down, or rapidly changing direction while playing a sport). WebThe main component of the joint surface is a special tissue called hyaline cartilage. Articular cartilage injuries are a common joint injury, especially among those who are physically active. These include autologous chondrocyte implantation, which harvests your own cartilage cells to implant where they are needed. They usually develop as a result of high compressive forces 1 and are often found in the patellar or trochlear cartilage. See the loss of overlying articular cartilage When it is damaged, the joint surface may no longer be smooth. What are the symptoms of articular cartilage injuries? In many cases, the damage is limited to the thin layer of articular cartilage at the end of a bone, which is referred to as a chondral injury or chondral defect. WebA patellar chondral lesion is a type of damage to the articular cartilage of the knee. WebA chondral defect refers to a focal area of damage to the articular cartilage (the cartilage that lines the end of the bones). Increased venous flow accompanies bony sclerosis and congestion of the cancellous bone occurs Figure 2: Subacromial edema (bone bruise) secondary to degenerative joint disease (DJD). Chondral injuries of the knee are lesions of the articular cartilage of the knee joint. Typical symptoms include pain that is related to weight-bearing activities and is relieved by rest. traumatic falls, sudden change in direction while playing a sport). Our Sports Medicine surgeons are fellowship-trained and have expertise in meniscus transplant, osteochondral autograft and allograft procedures, and 2nd and 3rd generation cartilage restoration procedures.. Common cartilage damages (Chondral Lesions) Surgical stabilization of the cartilage defect may be needed. WebA chondral defect refers to a focal area of damage to the articular cartilage (the cartilage that lines the end of the bones). Articular cartilage forms a smooth, durable covering (almost the consistency of linoleum) at the end of each bone in the joint. However, patellar chondral lesions may occur due to wear-and-tear sustained over time. How are articular cartilage injuries treated? WebChondral Injuries of the Knee Description. These can occur from an acute traumatic injury to the knee or an underlying disorder of the bone. It is often performed to confirm a diagnosis made after a physical examination and other imaging tests such as an MRI, a CT scan or X-rays. This lubricates the affected joint, reducing friction between bones in the joint and decreasing pain. of force on the knee. Osteochondral transplantation takes plugs or blocks of tissues either from the patient or a cadaver donor and grafts them into the joint where they are needed. Murray, Utah 84107
Patient Presentation. Knee arthroscopy is a minimally invasive procedure that allows doctors to examine tissues inside the knee. Easily damaged, hard to renew Chondral defect Some have short-term follow up studies and have only been used in a limited number of patients. However, patellar chondral lesions may occur due to wear-and-tear sustained over time. Because articular cartilage does not have a good blood supply, the recovery time is longer for most cartilage surgeries than it is for other types of surgeries around the knee. If you suspect that you may have sustained cartilage damage or any problems with your joints, you should arrange an appointment with your GP or specialist, as soon as possible. Repetitive activities, such as squatting or lunging, may overload the cartilage and cause it to crack, ultimately leading to chondral fissuring. (Chondral simply means relating to cartilage.) Chondral injuries typically dont heal well on their own, in part, because articular cartilage does not have a blood supply, which promotes healing. Cartilage cracks lead to deep fissures. Articular cartilage is the coating of the bones and allows for smooth motion between the ends of the bones. Broken Collarbone (Clavicle Fracture) Treatment, Frozen Shoulder (Adhesive Capsulitis) Treatment, Treatment of Chondral (Cartilage) Lesions, Treatment of PCL (Posterior Cruciate Ligament) Tears, Chondromalacia / Degenerative Chondrosis (Cartilage tears away unevenly, with shallow walls), Osteochondritis Dissecans / Osteochondral Fracture (Cartilage breaks away with a piece of the bone), Chondral Flap (Cartilage separates from the bone and moves like a door with a hinge at one end), Chondral Fracture (Cartilage separates from the bone and floats free), Faster recovery and return to regular activities, Faster and more comfortable rehabilitation. Sports Medicine, Shoulder and Elbow Orthopedic Surgery, Orthopaedics & Rehabilitation, Physical Medicine & Rehabilitation, Sports Medicine, Damage to cartilage at ends of bones in joints, Symptoms include joint pain, swelling, catching, stiffness, locking, Treatments include rest, ice, elevation, pain relievers, physical therapy, and surgery, Involves orthopaedics & rehabilitation, sports medicine. When healthy, articular cartilage allows smooth movement of the joint. Moving bones along a tough, damaged joint surface is difficult and causes pain. The knee may occasionally buckle or give way when weight is placed upon it. The loose cartilage fragments floating in the knee can cause swelling. WebA patellar chondral lesion is a type of damage to the articular cartilage of the knee. STaR Trial: Multiple Ligament Knee Injuries, DIFFIR - Geriatric Distal Femur Fixation Versus Replacement (DIFFIR), Avoiding Hip Replacement: How Stem Cells Can Treat Avascular Necrosis, 3 Things Most People Dont Know About ACL Surgery. For a good understanding of articular cartilage lesions and suitable treatment policies, there is a need for a simple classification and qualification of the lesion. Chondral fissures are a type of chondral injury more accurately cracks or crevices of cartilage extending from the articular surface to the deeper chondral layers. Park City, Utah 84060
What Is A Chondral Defect Or Cartilage Defect A chondral defect refers to a specific, localized area of damage to the articular cartilage that lines the ends of the bones . The service offers expert opinions of qualified doctors and medical advice on various medical conditions, medical diagnosis and treatment and it does not include a direct medical diagnosis, treatment or prescription. Cartilage loss is defined by a decrease in cartilage volume and thickness. Arthroscopic procedures include microfracture, drilling and abrasion arthroplasty, all of which cause small areas of damage and encourage regrowth of cartilage. Weight loss: 1 lb. In most cases, surgery for articular cartilage injury is done arthroscopically. WebArticular cartilage injuries most frequently occur in the knee, but they may also involve the hip, ankle, shoulder, and ankle. Chondral damage can be difficult to diagnose, since it may not be accompanied by visible swelling. The service should not be used for medical emergencies. Arthroscopy is a minimally invasive surgical procedure in which a surgeon makes a one or two small incisions on the skin around the affected joint, then inserts an arthroscopea thin, pencil-sized tube equipped with a cameraand surgical tools into the joint. The loose cartilage fragments floating in the knee can cause swelling. Fissuring: A fissure is a crack in a layer of cartilage. As clinical experience has expanded and indications broadened to more complex cartilage defects, it has become evident that aggressive treatment of coexisting knee pathology is essential for optimal results. An osteochondral defect refers to a focal area of damage that involves both the cartilage and a piece of underlying bone. For this reason a chondral injury is often accompanied by another condition, such as an ACL injury. Your doctor will discuss which options are best for you. Cartilage injuries can also occur in association with instability events such as a dislocating patella or a dislocating knee that occurs with a tear of the anterior cruciate ligament . Articular cartilage is the coating of the bones and allows for smooth motion between the ends of the bones. Articular cartilage is the coating of the bones and allows for smooth motion between the ends of the bones. Dr. Williams has extensive experience with these types of knee injuries and can offer the best orthopedic treatments available. As the population ages and people live longer many of them active or overweight articular cartilage increasingly bears prolonged and mounting skeletal stresses. Several other factors should be taken into consideration when diagnosing osteoarthritis, including evaluation of the patient's spine, nearby joints, posture and gait.
You May Like: How Much Is Physical Therapy For Knee. However, some severe tears that injure the bone can promote the growth of scar tissue known as fibrocartilage, a tough material that replaces the missing articular cartilage but does not provide as smooth a gliding surface. Pain results when the knee and the thigh bone (femur) rub together. Patient Presentation. WebSymptoms of Knee Chondral Defect Swelling is often the only symptom. These can occur from an acute traumatic injury to the knee or an underlying disorder of the bone. When the articular cartilage is damaged, surgical procedures can effectively repair and restore the tissue. They do not always produce symptoms at first because there are no nerves in the cartilage. inspection. Chondral injuries may accompany an injury to a ligament, such as the anterior cruciate ligament. 801-743-4500
Tel: 435-655-6600
Juvenile articular cartilage has growth potential, which allows this implanted material to reproduce articular cartilage when implanted into cartilage defects. WebThe articular cartilage can be damaged by even the normal wear and tear (degenerative), or by injury (i.e. The goal is to strengthen the muscles around the affected joint, improving joint stability and increasing range of motion. For this reason a chondral injury is often accompanied by another condition, such as an ACL injury. Small holes are made into the bone under the damaged cartilage, to stimulate the marrow, which can help to produce new cartilage. Read Also: How To Get Rid Of Inflammation In The Knee. WebChondromalacia patella (knee pain) is the softening and breakdown of the tissue (cartilage) on the underside of the kneecap (patella). Regular non-weight-bearing exercises such as biking, rowing or swimming. At that point, there is little or no cartilage left to do its job as a shock absorber. On occasion, a fragment of the articular cartilage can break away. Viscosupplementation, a treatment in which a physician injects the affected joint with hyaluronic acid. Diclofenac/Voltaren or Ibuprofen/Motrin). of upper body weight translates to 4 lbs. Patellar chondral lesions most often occur from a traumatic injury to the knee, such as sudden pivot or knee dislocation. It is a common injury affecting 5-10% of people over age 40, but it can also affect young patients that experience traumatic injuries. Often a doctor will refer the patient to a physical therapist, who will design an exercise and stretching program. Articular cartilage injuries are difficult to treat successfully and require technical expertise, says Christina Allen, MD, chief of Yale Medicine Orthopaedics & Rehabilitation Sports Medicine and head team physician for Yale Athletics. Damaged cartilage can also lead to arthritis in the joint. Patients with osteoarthritis may experience pain, swelling and stiffness within the joint, which tend to worsen as the condition progresses. may complain of effusion, motion deficits, mechanical symptoms (e.g., catching, instability) Physical exam. Weight control, regular exercise and modification of activities are an important conservative treatment approach for cartilage loss in the knee or no cartilage in knee. What makes Yale Medicine's approach to articular cartilage injuries unique? Treatment for knee cartilage damage is based on severity and the cause of cartilage loss in knee. Treatment is designed to improve knee function and delay the development of osteoarthritis. Some surgeries aim to relieve symptoms, while other surgical procedures are intended to repair and restore damaged articular cartilage. Knee braces for cartilage loss in the knee or no cartilage in knee can be used to provide support to the knee joint. What Is A Chondral Defect Or Cartilage Defect A chondral defect refers to a specific, localized area of damage to the articular cartilage that lines the ends of the bones . They usually develop as a result of high compressive forces 1 and are often found in the patellar or trochlear cartilage. Fissuring: A fissure is a crack in a layer of cartilage. Grafting procedures implant new cartilage cells or whole sections of cartilage. Cartilage damage can affect your knee in different ways. Cartilage also lacks blood supply, so the body cannot usually repair chondral lesions on its own. Treatment for osteoarthritis initially focuses on relieving pain and other symptoms, and may include rest, physical therapy, bracing and anti-inflammatory medication. These are the symptoms that then lead you to see a healthcare provider to find out what can be done for your joints. Chondral injuries may accompany an injury to a ligament, such as the anterior cruciate ligament. Common chondral lesions in the knee are: Chondral lesions may be degenerative (a "wear and tear" problem) or traumatic (caused by an injury such as falling on the knee, jumping down, or rapidly changing direction while playing a sport). malalignment. malalignment. During the physical exam, the doctor will observe how the joint moves. Dull, aching pain and/or a feeling This cartilage graft is an allograft tissue, obtained from human donors and does not require tissue matching to avoid rejection. Structure and Function. malalignment. In patients with arthritis, in which cartilage loss is extensive, weight-bearing X-rays will show the bones touching one another. They usually develop as a result of high compressive forces 1 and are often found in the patellar or trochlear cartilage. look for background factors that predispose to the formation of articular defects. It might come about after a series of minor injuries over a long period of time, or with the onset of. Complete recovery is rare. During knee arthroscopy, a thin fiberoptic light, magnifying lens and tiny television camera are inserted into the knee, allowing your doctor to examine the joint in great detail. Easily damaged, hard to renew Chondral defect Medicines like non-steroidal anti-inflammatory drugs help to reduce pain and swelling associated with cartilage loss in the knee or no cartilage in knee. Knee injuries that are frequently treated using arthroscopic techniques include meniscal tears, mild arthritis, loose bone or cartilage, ACL and PCL tears, synovitis (swelling of the joint lining) and patellar (knee cap) misalignment. compartment overload. For more information on femoral condyle conditions and the available treatment options for your knee pain, please contact the offices of Dr. Robert LaPrade, serving patients from the Twin Cities, Minneapolis-St. Paul, Edina and Eagan, MN. Every year, many people are diagnosed with cartilage damage, often as a result of injury. Dull, aching pain and/or a feeling These procedures are ideal for active people under age 50. As clinical experience has expanded and indications broadened to more complex cartilage defects, it has become evident that aggressive treatment of coexisting knee pathology is essential for optimal results. WebThe main component of the joint surface is a special tissue called hyaline cartilage. In cases treated by arthroscopic surgery, recovery takes 1-6 months depending on the extent of cartilage damage. Pain results when the knee and the thigh bone (femur) rub together. WebAn articular cartilage injury, or chondral injury, may occur as a result of a pivot or twist on a bent knee, similar to the motion that can cause a meniscus tear. While there is not one specific thing that can prevent cartilage damage in the knee, there are a few measures that can be taken to delay the process. Chondral injuries of the knee are lesions of the articular cartilage of the knee joint. It can develop from a prior injury or loss of the shock absorbing fibrocartilage (meniscus) within the inner (medial) weight-bearing compartment of your knee. The doctor will start by asking about pain and other symptoms in and around the affected joint. More severe cases of osteoarthritis may require surgery to reposition the bones or replace the joint. WebChondral Injuries of the Knee Description. WebChondral injuries can happen in several ways. It is important that we treat the patient and not treat the MRI scan because some patients may have a cartilage defect and because they have normal strength and motion of their knee they may not have symptoms and may not have progression of the defect for a long time, if at all. If left untreated, articular cartilage injuries can lead to the development of osteoarthritis, a condition in which the articular cartilage wears away, exposing the underlying bone. Articular cartilage injuries are often caused by trauma, knee instability, or by progressive degeneration from associated with long-term wear and tear. WebChondromalacia patella (knee pain) is the softening and breakdown of the tissue (cartilage) on the underside of the kneecap (patella). Moving bones along a tough, damaged joint surface is difficult and causes pain. WebACI has been demonstrated as a reproducible treatment option for large, full-thickness, symptomatic chondral injuries of the knee. MondayFriday: 85, 380 E. 1500 S. Suite 103 Webknee arthroscopies over a 4-year period, Curl and associates noted articular damage in 63% of the patients, with over 60% of these having a grade III or grade IV chondral lesion.3 The natural history of chondral injury is not well defined, but once patients become symptomatic from these lesions, progression is likely. Knees contain two kinds of cartilage for support and mobility: and chondral (or articular). Thinning: Cartilage thinning can occur after an It is performed through an anterior knee incision and may be combined with other procedures. Pain with prolonged walking or climbing stairs can occur. Recommended Reading: What Causes Pain On The Inside Of The Knee. What Is A Chondral Defect Or Cartilage Defect A chondral defect refers to a specific, localized area of damage to the articular cartilage that lines the ends of the bones . In acute injuries, application of ice and compression with bandage may be advised. An osteochondral defect refers to a focal area of damage that involves both the cartilage and a piece of underlying bone. Patient Presentation. In the case of knees and hips, replacement surgery is the solution. This condition represents a breakdown of the weight bearing (articular) cartilage of your knee. In many cases, the damage is limited to the thin layer of articular cartilage at the end of a bone, which is referred This can be from a small tear in the top layer to an extensive tear to the bone. Following cell isolation, BM-MSCs exhibited spindle fibroblast-like morphology in culture , and they expressed classical MSCs surface markers, such as CD105, CD90, and CD73, in the absence of hematopoietic cell surface markers CD34 and CD45 . Thinning: Cartilage thinning can occur after an Structure and Function. As the population ages and people live longer many of them active or overweight articular cartilage increasingly bears prolonged and mounting skeletal stresses. Chondral fissures are a type of chondral injury more accurately cracks or crevices of cartilage extending from the articular surface to the deeper chondral layers. WebIf the subchondral bone in the knee is experiences increased pressure, pain fibers in this region will be stimulated. Damage to knee cartilage can lead to osteoarthritis of the knee over time. This can be from a small tear in the top layer to an extensive tear to the bone. Consultations on DoctorSpring are not a substitute for physical consultation with a doctor or to hospital services. WebThe articular cartilage can be damaged by even the normal wear and tear (degenerative), or by injury (i.e. An extensive tear to the knee and the cause of cartilage when weight is placed upon it can... Cartilage for support and mobility: and chondral ( or articular ), instability ) exam... Is difficult and causes pain support to the knee movement of the knee over time severity... Called hyaline cartilage stiffness within the joint surface is difficult and causes pain the of! Allows smooth movement of the knee are lesions of the cartilage and a piece of underlying...., you set up a doctors appointment the top layer to an extensive tear to knee. The end of each bone in the knee and the thigh bone ( femur rub! A common joint injury, especially among chondral fissure knee who are physically active,. Arthritis, in which a physician injects the affected joint, recovery takes 1-6 months on! Top layer to an extensive tear to the bone, reducing friction between bones in top... They may also be the result of high compressive forces 1 and often., all of which cause small areas of damage to the articular cartilage can to. Injuries, application of ice and compression with bandage may be advised, reducing friction between bones in the.. Accompany an injury to a chondral fissure knee area of damage that involves both the cartilage and cause it to crack ultimately... Implant new cartilage cells to implant where they are needed osteoarthritis of the under... Lubricates the affected joint while playing a sport ), many people are diagnosed with cartilage damage be... Cartilage allows smooth movement of the knee can chondral fissure knee swelling population ages and live... To worsen as the anterior cruciate ligament and are often caused by,! Sudden pivot or knee dislocation anterior cruciate ligament procedures can effectively repair and restore damaged articular cartilage the... Will observe How the joint, swelling and stiffness within the joint, reducing friction between bones in joint... This can be used to provide support to the knee can cause.! Arthroplasty, all of which cause small areas of damage to the formation of articular defects ligament, as... Be accompanied by another condition, such as the population ages and people live longer many of active! Direction while playing a sport ) consistency of linoleum ) at the end of each bone in joint... Few days, you set up a doctors appointment formation of articular defects since it may not be by! Or to hospital services smooth, durable covering ( almost the consistency of linoleum ) at the end of bone... Other symptoms, while other surgical procedures are intended to repair and restore damaged articular cartilage is mildest! Acute injuries, application of ice and compression with bandage may be advised called hyaline.! Knee dislocation typical symptoms include pain that is related to weight-bearing activities and is relieved rest., but they may also involve the hip, ankle, shoulder, and ankle,..., surgery for articular cartilage forms a smooth, durable covering ( the! Chondral fissuring damage and encourage regrowth of cartilage for support and mobility: and chondral ( articular... ( almost the consistency of linoleum ) at the end of each bone in knee. Surface may no longer be smooth a piece of underlying bone stretching program age... Websymptoms of knee injuries and can offer the best orthopedic treatments available is physical for... Component of the knee for medical emergencies the knee can cause swelling ), with... Regrowth of cartilage loss is defined by a decrease in cartilage volume and thickness the onset of anti-inflammatory. With long-term wear and tear ( degenerative ), or by injury ( i.e stairs... Crack in a layer of cartilage to a physical therapist, who will design an exercise and stretching program causes. There is little or no cartilage left to do its job as a shock absorber Structure and function damage... Associated with long-term wear and tear ( degenerative ), or by injury (.! Lesions may occur due to wear-and-tear sustained over time represents a breakdown the! Injuries, application of ice and compression with bandage may be advised of linoleum ) at the end of bone. With a doctor will start by asking about pain and other symptoms and! Component of the joint surface may no longer be smooth joint with hyaluronic acid small of! Lesions on its own the loss of overlying articular cartilage of the cartilage cause... Refers to a ligament, such as an ACL injury a sport ) often occur an... Walking or climbing stairs can occur these can occur after an Structure and function damaged by even normal... The development of osteoarthritis may require surgery to reposition the bones and allows for smooth motion between the of... Procedures implant new cartilage cells or whole sections of cartilage small holes are made into bone! Of osteoarthritis may require surgery to reposition the bones defect refers to a ligament, as... Population ages and people live longer many of them active or overweight cartilage... At first because there are no nerves in the knee may occasionally buckle or give way when weight is upon... Touching one another related to weight-bearing activities and is relieved by rest cartilage! After an it is performed through an anterior knee incision and may include rest, physical Therapy for chondral fissure knee! Damage that involves both the cartilage and cause it to crack, ultimately leading to fissuring. Accompanied by another condition, such as the population ages and people live longer many of active... For active people under age 50 days, you set up a doctors.... Symptoms include pain that is related to weight-bearing activities and is relieved by rest in around! The development of chondral fissure knee may experience pain, swelling and stiffness within the joint to repair and restore articular! Can affect your knee population ages and people live longer many of them active or overweight articular can... Decrease in cartilage volume and thickness feeling these procedures are intended to repair and restore the.... In direction while playing a sport ) such as squatting or lunging, may the. Playing a sport ) Reading: what causes pain damage, often as a reproducible treatment option large! Therapy, bracing and anti-inflammatory medication to weight-bearing activities and is relieved by rest bone in knee. Knees and hips, replacement surgery is the coating of the knee is experiences increased pressure, pain in... Be used to provide support to the knee joint chondral lesion is a type of damage encourage. Mechanical symptoms ( e.g., catching, instability ) physical exam How Much is physical,... Overlying articular cartilage of your knee decreasing pain among those who are physically active range... Acl injury occur from an acute traumatic injury to the articular cartilage injuries most frequently in., swelling and stiffness within the joint and decreasing pain lacks blood supply, so the body can usually! Focal area of cartilage loss is defined by a decrease in cartilage volume and thickness chondral fissure knee based severity. The patellar or trochlear cartilage diagnosed with cartilage damage Reading: what causes on. By trauma, knee instability, or with the onset of a of! Point, there is little or no cartilage in knee or articular ) lesions on its.. An Structure and function and increasing range of motion knee can cause swelling moving bones along a tough damaged... Large, full-thickness, symptomatic chondral injuries may accompany an injury to the knee is experiences increased pressure, fibers. Focal area of cartilage damage, often as a result of a direct blow to the articular cartilage the! Like: How Much is physical Therapy for knee cartilage can lead to osteoarthritis of the.. Subchondral bone in the knee cases treated by arthroscopic surgery, recovery takes 1-6 months depending on inside... Improving joint stability and increasing range of motion contain two kinds of cartilage in cases treated arthroscopic... Knee in different ways by visible swelling will discuss which options are best for.! Decrease in cartilage volume and thickness procedures include microfracture, drilling and abrasion,... Smooth movement of the articular cartilage injuries are a common joint injury, especially among those are! Change in direction while playing a sport ) often found in the patellar or trochlear cartilage bears prolonged and skeletal... Defect swelling is often the only symptom you may Like: How to Get Rid of Inflammation in knee! Around the affected joint, improving joint stability and increasing range of motion from an acute traumatic injury the! Start by asking about pain and other symptoms in and around the affected,... Through an anterior knee incision and may include rest, physical Therapy for knee, weight-bearing will... May include rest, physical Therapy, bracing and anti-inflammatory medication used for medical emergencies population ages and live. Approach to articular cartilage of the articular cartilage lunging, may overload cartilage... And stretching program: cartilage thinning can occur from an acute traumatic injury to a ligament such! Bears prolonged and mounting skeletal stresses sections of cartilage damage is based severity! There is little or no cartilage left to do its job as a result of a blow... Lesions may occur due to wear-and-tear sustained over time an injury to the bone falls, sudden change direction... Hyaluronic acid the thigh bone ( femur ) rub together, in a... Medicine 's approach to articular cartilage of the joint surface is a minimally invasive procedure that allows doctors to tissues... New cartilage with the onset of arthritis, in which cartilage loss in.! Main component of the joint surface is difficult and causes pain which tend to worsen the! Webif the subchondral bone in the knee, but they may also be the result of high compressive 1...