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Chondropathia is a degenerative (wear or arthrosis) lesion that affects the entire joints of the knee and its functioning. First, the cartilage structure covering the joints changes: the earlier plain surface is cracked, “softens”, then gets deeper crevasses and the cartilage is removed in some places. At the end of the degenerative lesion, they may be completely free of cartilage parts, causing significant pain and loss of function in the joints.
Arthrosis, however, affects not only the cartilageous surfaces but also the structure of the bone under the cartilage: they are thickening, sometimes small bone cavities, degenerative cysts are produced – the latter’s cavity is connected to the joint. The synovial fluid pressed into them can cause serious pain during any movement.
Arthrosis appears to some extent in all joints with age but the frequency of occurrence and the degree of severity are very different. Mostly the small joints of the hands, hips, knees and spine are affected. Changes in degenerative disorders are primarily related to age, wear and tear of the joint. There are some factors that can accelerate these processes, for example, an altered joint structure or disorder that has been caused by a previous injury. As with many other locomotor disorders, it is also true for arthrosis that genetic factors play a role in its development.
Complaints occur more intense or discreet depending on the magnitude, depth, and location of the lesion.
Symptoms may vary; load, exercise are mostly obstructed, but it may even be asymptomatic for a long time. Usually, complaints cannot be localized to a certain location.
Anterior cruciate ligament (ACL) injuries mostly occur during sports that involve sudden stops, jumps or changes in direction. These cause the lateral displacement of the knee, with twisting at the same time, which lead to the torn of the ligament. It is common between skiers, footballers, handball and volleyball players if they foot returns to the ground at a wrong angle. Because of the different forces at the same time, these injuries are often accompanied with the lesion of the collateral ligaments or the meniscus.
When the ligament is damaged, there is usually a partial or complete tear across the tissue.
In the case of surgical treatment of cartilage damage, the primary goal is to curb the lesion and, if possible, to initiate the regeneration processes at the site of the damage. In order to stop the further separation of degenerated cartilage parts the frayed cartilage is removed and the surface must be smoothed.
In the recovery process of the joints, the mechanical role of shavers (“shavings”) is primarily due to the fact that a regeneration process starts in the treated areas. Surfaces will be covered with a fibrous cartilage coating, so abrasion will slow down as a coating layer is formed on the surfaces.
If we are facing greater cartilage surface damage, after the cleansing the cartilage surfaces the cartilage surface simulation, the so-called microfracture surgery (drilling) is the safest routine procedure. In addition to proper rehabilitation in the area concerned, so-called “glass-like fibrous cartilage” (hyaline cartilage) can develop, which does not correspond to the original one histologically and in terms of its load capacity, but in many cases, highly loadable cartilage is formed.
In the first few days after the operation, the joints are recovering from the operation. There is a need for rest because during the arthroscopy procedure the lubricant of the joints is “washed out”, and the reproduction of the joint moisture requires at least three days.
After the cartilage surgery, it is crucial to fully relieve the knees to recover 6 to 8 weeks using two crutches. If the said period is over, the treated surface becomes strong enough to prevent the coating layer from breaking down it is not going to compress the cartilage surface for less load or footstep.
Only the physiotherapy required by the physiotherapist can be performed with the operated foot, and muscle strengthening and stretching exercises can begin. If the relief process is not done consistently or the physiotherapy starts too early, the surface coating process fails, the surfaces practically remain free and the harmful enzymes from the bone can get almost unhindered to the joint fluid. Thus, the abrasion process continues, even if short-term improvement has been recognized. In order to make the regeneration process more intensive in the treated areas, a few weeks after hyaluronic acid or polynucleotide injection can be given to the joints.