Chondropathy is a degenerative (caused by gradual wear or arthrosis) lesion that affects the entire knee joint and its functioning.
The first thing to suffer structural changes is the cartilage covering the joint: the previously smooth surface becomes cracked.
As the crevasses become deeper, the cartilage falls off in some places. After a while, some parts of the joint may become completely exposed as the cartilage slowly disappears, causing significant pain and loss of function in the joint.
Arthrosis affects not only the cartilage but also the bone structure that lies unterneath: the bone starts to thicken, small cavities form within, and degenerative cysts may develop. In the latter case the presence of synovial fluid any movement involving the knee joint may be accompanied by severe pain.
Arthrosis can appear in any joint as people age but the frequency of occurrence and the degree of severity can be very different depending ont he body part. Usually the small joints of the hands, hips, knees and spine are affected. Degenerative changes are primarily age-related, caused by the gradual wear and tear of the joint. There are some factors that can accelerate these processes, an altered joint structure due to previous injury for instance. Genetic factors also play a role in the development of chondropathy.
The intensity of the pain and other complaints is closely related to the extent, depth, and location of the degenerative changes.
Symptoms may vary; weightbearing exercise usually causes discomfort, but some patients can even be asymptomatic for long periods of time. Usually, pain and other complaints affect a larger area and cannot be pinpointed.
Anterior cruciate ligament (ACL) injuries mostly occur during sports activities involving sudden stops, jumps or changes in direction. These activities cause the knee to move laterally, while it is being twisted at the same time, resulting in a tear of the ligament. It is a problem well known to skiers, footballers, handball and volleyball players who have a tendency to jump and land a lot. As there are a number of opposing forces at play at the same time, these sports injuries are often accompanied by damage to the collateral ligaments or meniscus. When the ligament is injured, it usually means a partial or complete tear across the tissue.
In case of damage to the cartilage, it is important to establish an accurate diagnosis. Your doctor will likely order a range of tests including a physical examination, an X-ray in weight-bearing position, and possibly an MRI. However, the extent of the damage can most accurately be detected during arthroscopic surgery.
Surgical treatment of chondropathy aims to prevent further damage to the cartilage, and if possible, to initiate tissue regeneration at the site of the damage. In order to stop the further separation of degenerated cartilage, the frayed part is removed and the surface is smoothed.
During recovery, a regenerative process starts in the areas where cartilage has been shaved. Ultimately, a fibrous cartilage coating appears on previously bare surfaces, and abrasion slows down as a result.
If cartilage damage affects a larger area, the cartilage surfaces are smoothed first, then a so-called microfracture surgery (drilling) is performed.
In the first few days after surgery, the joints are expected to be recovering from the operation. You need to rest because during the arthroscopic procedure the lubricant of the knee is washed out, and the joint needs at least 3 days to start producing moisture again.
After cartilage surgery it is crucial to let the knees heal by using elbow crutches for 6 to 8 weeks. By the end of that period, the joint will be strong enough to bear your weight without irritatation to the fine coating of the cartilage surface.
Physiotherapy will be required, you will be expected to follow the excercise routine your psysiotherapist will have taught you. These are designed to help strengthen and stretch your muscles. It is very important to follow the instructions carefully because if you start moving to early or do the excercises inconsistently, you might end up causing more harm to the fragile cartilage. In some cases hyaluronic acid or polynucleotides are injected into the joint to improve tissue regeneration.
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