Life is motion, motion is life. I think this one statement sums up the philosophy of human locomotion. If we stop moving, then life comes to a standstill not just physically, but mentally as well. The organ that is responsible for the motion is our joint. Our joint moves because of muscles and muscles are able to move the joint smoothly because of the cartilage. In this week’s column, we will discuss the importance and issues associated with cartilage wellbeing.
Cartilage is a firm white glistening structure much like the inner side of a coconut. Cartilage covers the inner side of a bone when they come close to each other to form a joint. Cartilages receive their nourishment from the bone side and also to a certain extent from the fluid that circulates within the joint. Unfortunately, the cartilage does not have any blood supply and does not have any nerve supply either. This particular fact makes it very vulnerable to degradation, once it sustains an injury or once it starts ageing as well. The lack of blood supply and nerve supply will not allow injured cartilage to regenerate. If the injured cartilage does not regenerate, there is a constant progressive forward process of degeneration, which leads to softening, fissuring, and breakdown, which ultimately leads to loss of cartilage. This will cause bare bone surfaces to grind on each other and thereby causes disabling arthritis.
Cartilage injuries usually may occur in the third, fourth and fifth decade as a result of injuries: road traffic, sports or domestic falls. An abnormal shearing force on the joint would result in either a breakdown or loss of cartilage. In this situation, the joint could be acutely inflamed, swollen and movement may be quite difficult. Luckily for us, improved imaging modalities like high resolution MRI scans are now able to pick up these injuries very early, which enable us to restore back the cartilage cover to normalcy and thereby result in a normal outcome. The second modality of cartilage injury is that of an over used trauma.
A lot of us who are engaged in overuse activities such as high intensity gymming work outs, contact sports, abnormal positions while walking would exert an abnormal force on the joint surface. If this abnormal force is applied for a long duration of time, the resultant cartilage cover starts breaking down because of lack of blood supply and this then leads to progressive cartilage loss with its resultant consequences. In these situations, it would be essential to have a change in the life style or work style and institute the necessary measures for making sure that these is no serious damage.
The last modality of cartilage wears would that be of progressive ageing with resultant deformity in the joint alignment. We know very well that such kinds of wearing off of the cartilage does have a significant genetic predisposition, which may lead to onset of wear and tear at an early age. Advanced progressive chondral damage, which results in severe arthritis probably, deserves nothing short of surgical treatment.
How do I prevent this? Prevention would be the key. We need to exercise daily. Exercises should be ideally non-impact,non-weight bearing for patients with pre-existing cartilage damage. For those who do not have any cartilage damage, a good aerobic and strengthening exercise program with flexibility exercises is beneficial. A good diet with healthy natural sources of Calcium, Vitamin D, Magnesium, Boron and Zinc work well for maintenance and health of a cartilage.
Next week, I will discuss the peculiarities of the current epidemic of the ‘Young Arthritic Knee’.
Dr Sachin Tapasvi is one of India’s leading joint replacement surgeons. He practises in Pune and has been awarded several fellowships with experience garnered internationally as well as in India.
- Dr. Sachin Tapasvi, ‘A Stitch in Time Saves Nine’ - December 15, 2016
- Dr.Sachin Tapasvi: Belts & Buckles of the Ortho Kind - November 9, 2016
- Dr Sachin Tapasvi: Trigger-happy? Ouch! - October 26, 2016
