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The cartilage surrounding the bone head is essential for the joint to bear all the stresses. Nature programmed it as a water damper.
Cartilageabsorbs water, "swells" and pressing this water out of it. It works in all joints, but the cartilage surrounding the heads of the femur and tibia in the knee joint is exposed to the greatest stress. Unfortunately, in the case of collisions and kicks from the side, the cartilage in the knee cannot cope with these loads.
Also, when we stay motionless for a long time and the cartilage "does not work" - it loses its efficiency. Not only because it does not fill with liquid. The cartilage of the motionless jointof the jointis simply starving. This tissue is not supplied with blood and it receives nutrients from the synovial fluid by diffusion.
If the mechanism of intake of water and food is disturbed, the cartilage begins to deteriorate. The degree of damage is assessed by the doctor on the basis of an ordinary X-ray image and a joint load.
Sometimes it is necessary to performmagnetic resonance imagingandarthroscopy , which is the most thorough examination, because the doctor not only looks at the cartilage, but can touch it .
Four degrees of cartilage damage:
- It has the right surface but is too soft.
- The superficial layer of cartilage is damaged, it loses its smoothness and looks like suede.
- The cartilage fractures are deep but do not extend to the bone.
- There are areas of bone that are not covered with cartilage.
How to protect cartilage from permanent damage?
In the first two cases, it is enough to reduce body weight, modify the performance of movements and increase physical activity, as well as apply rehabilitation to protect the cartilage from further damage. Sometimes drug therapy is used.
How to regenerate damaged articular cartilage?
In the third and fourth cases, the damage is significant and the cartilage cannot regenerate on its own. The joint hurts, "clicks", shoots, swells. However, medicine can recreate such damaged cartilage. All thanks to the discovery of stem cells and their counterparts in individual tissues and in the blood - pluripotent cells, and investigating the mechanisms of their use inregeneration processes. This way it is possible to recreate damaged cartilage in different joints.
An older method of rebuilding cartilage is to make an incision that causes blood to flow into the joint. Multi-potential cells form a scar that recreates cartilage.
Reconstruction with in vitro cultured chondrocytes
A newer method is to collect special cells from the patient's he althy cartilage - chondrocytes. Therefore, an undamaged piece of cartilage is collected and chondrocytes are isolated from it in the laboratory. Then they have to be bred in vitro so that there are enough of them. The amount depends on the size of the cartilage you need to replace. The cultured cells are filled with a biotechnological collagen membrane and glued with tissue glue in place of the cartilage defect. The procedure is performed arthroscopically. One year after the procedure, the cartilage is regenerated enough to allow you to exercise normally.