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Chondral Injuries

WHAT IS IT?

These are injuries affecting joint cartilage, which is the tissue that makes the painless movement between two bone surfaces possible. These injuries can be classified in terms of extension and depth.

Depending on the extension of the cartilage damage, they are classified as focal (osteochondral fractures, osteochondritis) or extended: degenerative injuries which start at cartilage level, extending to bone damage (osteophytes, sclerosis), calling for the term arthrosis.

Depending on the depth of the cartilage damage, they are classified as surface injuries: grade I and II chondropathy; medial injuries: grade III chondropathy; and injury affecting the whole thickness of the cartilage: grade IV chondropathy.

CAUSES

Recurring diseases and microtraumas may degenerate the biological environment of the cartilage (the cells and extracellular matrix), leading to chondral defects. These may also be caused by traumas or processes of wear and degeneration.

SYMPTOMS

The most noteworthy among the main symptoms of these chondral injuries are joint pain, leakage-inflammation, clicking and jamming.

TREATMENT

As a base treatment, weight-loss is recommended, as well as muscle-building exercises keeping the weight off the limb, the use of supportive arch orthoses if necessary (for instance, in cases of genu varum or bow-leggedness) or heel cups, oral chondroprotectives and intra-articular injections of Hyaluronic acid.

Nowadays, depending on the degree of injury, your doctor may propose conservative treatment using PRGF® Endoret® which consists in intra-articular injections containing growth factors (PRGF® Endoret®) administered weekly, on an outpatient basis, for three consecutive weeks and with maximum asepsis.

If prior treatment should fail, or depending on the extent of the damage caused by the injury, surgical treatment will be recommended, allowing the use of reparative techniques such as the Pridie drilling technique, abrasive chondroplasty, microfracture surgery, reconstructive techniques like Autologous osteochondral grafting or allotransplantation and osteotomy.

In the case of osteochondral fractures – and, in some cases, osteochondritis  – osteosynthesis is applied using metallic, re-absorbable or biodegradable pins.

In all cases of surgery, the PRGF®-Endoret® technology is used during the procedure as well as on an outpatient basis following surgery (see also: treatment of osteochondritis dissecans).