On this website, you can find useful, updated information on specific cartilage-related conditions and possible treatments options, written by world-renowned experts in this field, helpful patient information to read and download, and other useful resources
The choice of procedures depends on the size and location of cartilage defect. Larger defects are typically treated with autologous chondrocyte transplantation, osteochondral allograft transplantation, or newer synthetic or natural scaffolds which may require open incisions. Smaller defects in specific locations may be treated with enhanced bone marrow stimulating techniques, autologous chondrocyte implantation (ACI), or osteochondral autograft transfer which may be completed through the arthroscope. There is also a chapter for conservative treatments options and rehabilitation after cartilage repair.
People of all ages can suffer from cartilage complications, whether due to ‘wear and tear’ or injury. While the former is much more common in middle-aged patients, and even more so in women, injuries to the joints, such as trauma or accidents during active sports, can affect any age group or gender. Careers requiring repetitive or intense motion can increase the risk of developing cartilage problems, but there are several other risk factors, including age, weight and genetic predisposition.
On this website, we focus only on articular cartilage repair treatments, which means the restoration of damaged hyaline cartilage in the joints. Cartilage repair and regeneration is a treatment for joints that have damaged cartilage but are otherwise healthy. Typically, these procedures are recommended for cartilage damage or deterioration caused by:
Injury or trauma, including sports injuries or repetitive use of the joint Congenital abnormalities – abnormalities a person is born with (for instance misalignment) – that affect normal joint structure Hormonal or idiopathic disorders that affect bone and joint development, such as osteochondritis dissecans (OCD). There are several types of new and modern procedures for cartilage repair and regeneration techniques that are designed to heal the cartilage by filling the cartilage defect (pothole) with repair tissue.
There are several types of bone and joint pain, each with many potential sources or etiologies. This site is not intended for people who suffers from rheumatoid arthritis (RA), gout, avascular necrosis (AVN), and cancer within bones, osteoporosis and other inflammatory or autoimmune diseases.
To the Mäxi Foundation:
This website project would not have been possible without the substantial support of the Swiss “Mäxi Foundation”. The ICRS would like to express a deep gratitude for this very generous contribution to the International Cartilage Repair Society and the respective patient community, making it possible to provide updated information about cartilage damage and cartilage repair technologies free of charge to all interested persons.
To the Authors & Contributors:
The following world-renowned experts in cartilage repair & cartilage research have contributed to the extensive content of this website: Stephen Abelow (USA), William Bugbee (USA), Susan Chubinskaya (USA), Brian Cole (USA), Stefano Della Villa (IT), Chris Erggelet (CH), Jack Farr (USA), Ralph Gambardella (USA), Michael Gerhardt (USA), Wayne Gersoff (USA), Alan Getgood (CA), Alberto Gobbi (IT), Laszlo Hangody (HU), Oliver Kessler (CH), Elizaveta Kon (IT), Jos Malda (NL), Bert Mandelbaum (USA), Tom Minas (USA), Kai Mithoefer (USA), Stefan Nehrer (AT), Lars Peterson (SE), Scott Gillogly (USA), Holly Silvers (USA), Jason Theodosakis (USA) and Kenneth Zaslav (USA)
To anyone else who contributed to this important project
ICRS Office Staff, Medical Writers, Committees, Illustrators and Web Developers, etc.
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Shoulder conditions, although less common than in the knee or hip, affect a large number of people; especially people aged over 50 years. Shoulder problems are associated with ongoing pain and places limitations on a person’s lifestyle, among other negative effects.
One of the most common shoulder conditions is arthritis. This is when the joint cartilage is damaged through wear or inflammation to such an extent that there is friction between the shoulder bones, causing pain and other complications. Similarly, inflammation of the shoulder joint lining can reduce movement, such as in ‘frozen shoulder’.
Other movement disorders include the relatively common ‘rotator cuff injury’, in which there is damage to the muscles controlling shoulder movement.
Depending on the type and severity of the shoulder problem, the treatment options vary greatly, and your doctor will be happy to discuss the next steps. While there are shoulder problems that predominantly involve bones, muscles or tendons, the information here is primarily a guide to disorders of shoulder cartilage (particularly arthritis) and their treatment to help inform your discussion with your physician.
People of all ages can suffer from shoulder complications, whether due to ‘wear and tear’ or injury. While the former is much more common in middle-aged patients, and even more so in women, injuries to the shoulder, such as during active sports, can affect any age group or gender.
Careers requiring repetitive or intense motion can increase the risk of developing shoulder problems, but there are several other risk factors, including age, weight and genetic predisposition.
People of all ages can suffer from shoulder complications, whether due to ‘wear and tear’ or injury. While the former is much more common in middle-aged patients, and even more so in women, injuries to the shoulder, such as during active sports, can affect any age group or gender.
Careers requiring repetitive or intense motion can increase the risk of developing shoulder problems, but there are several other risk factors, including age, weight and genetic predisposition.
For proper movement, the joints of the shoulder need lubrication, which comes from the cartilage. Arthritis (inflammation of the joint) affects this carefully maintained system, causing discomfort, pain and, in some cases, the need for surgery. Arthritis is further divided into two categories: osteoarthritis and rheumatoid arthritis.
Osteoarthritis, the more common of the two, is due to ‘wear and tear’ of the joint cartilage. It is more likely in older patients, although can develop after fracture. Sufferers have pain and ache in the shoulder joint, often at the top and front. The pain is typically worse in the morning and at night. Reduced range of motion and flexibility makes sleep or daily activities difficult.
Rheumatoid arthritis is caused by an over-active immune response. In other words, the body’s natural defences attack the joint lining. Pain, swelling/inflammation, reduced range of motion, and lumps or tender spots are all symptoms. Over long term, rheumatoid arthritis can cause distortion of the bones.
Although neither type of arthritis is curable, the symptoms can be managed and treated in a number of ways, including physical therapy to improve joint lubrication, medication to combat pain and inflammation, and lifestyle changes such as rest and weight loss. In more extreme cases, other techniques or surgery may be necessary. For osteoarthritis in particular, cartilage restoration is a possibility.
Your physician will assess the severity of the condition and approach it in several stages. These may include physical therapy, anti-inflammatory drugs and steroid injections. In more extreme cases, there are a number of surgical options, including shoulder replacement, bone reshaping and procedures to reduce tendon problems. These options can be discussed with your orthopaedic surgeon.
There are now many promising methods to restore and repair cartilage in the shoulder. These offer alternatives to synthetic joint replacements and other surgical methods, and help to restore function using more natural tissue. These include:
Outcomes with these techniques will depend on the age of the individual, the size and location of the cartilage defect, and the postoperative rehabilitation.
Many shoulder conditions, given time, can be treated effectively with non-surgical methods, which helps to reduce pain and offer better range of motion. Newer cartilage repair options, such as those mentioned above, are also extremely promising, and can offer years of relief from pain. In many cases, sufferers can return to active, healthy lifestyles.
If surgical intervention in the form of shoulder replacements, tendon surgery or bone reshaping is thought necessary in the long term, there are a range of successful, proven options that can be discussed between the patient and surgeon.
Depending on the condition and treatment, recovery from common shoulder disorders can take up to 8 to 12 months. Completely pain-free, full-range of motion of the shoulder may be difficult to obtain in some cases.
It is therefore important to manage expectations, and set goals that take into account the achievable lifestyle benefits and improvements versus the time required.
This depends on both the severity of the condition and the individual circumstances of both the surgery and your work life. Some people may be able to return to less-demanding work after days or weeks, but it may take months for those in more active roles to be fit for work.
Being as fit as possible prior to surgery is important. This includes stopping smoking and losing excess weight. Following surgery, it is essential to remain in close contact with your physical therapist, and doctor (where appropriate) to make sure your rehabilitation is effective.
