Bone and joint cartilage damage, can it be recovered?
I believe everyone may know that the cartilage in our joints is very important. This layer of cartilage is full of elasticity and is used to lubricate our joints and buffer The pressure in our joints plays a very important role. Once the cartilage is damaged, it will easily lead to subchondral bone sclerosis, bone capsule degeneration, and the formation of osteophytes (bone hyperplasia), which will eventually lead to The occurrence of arthritis.
Once cartilage is damaged, it is very slow to repair and non-renewable, so the treatment effect is often not ideal, so there is a saying that Once the cartilage is damaged, the joint is no longer healthy and needs no treatment.
Is this really the case?
Today, Dr. Xie wants to share a case with you. To be honest, Dr. Xie did not expect this patient to recover so well. The damage to the internal subchondral bone has been significantly alleviated, which is very rare. This case must be shared with you.
Real Cases
This patient is the lover of a friend of Dr. Xie. In 2018, due to knee pain, cannot go up and down the stairs normally, and his knees snap when squatting , to the hospital for treatment. At that time, the eldest brother weighed nearly 220 pounds. After examination, it was found that the patient’s articular cartilage had obvious wear and tear, and the subchondral bone under the cartilage had obvious bright signals, which indicated that the patient The pressure in the patella and femoral joint increased significantly, resulting in cartilage damage, resulting in the appearance of edema, and induced the above symptoms in patients.
The reason for this injury is related to the patient’s weight and previous exercise history. Doctors suggest that patients must lose weight and control their physical activity. If the pain cannot be controlled, intra-articular injection of sodium hyaluronate can be given to relieve symptoms, and patients are also advised to regularly oral ammonia sugar, and rehabilitation exercises as appropriate.
To be honest, at that time, Dr. Xie felt that the patient’s symptoms would not be relieved very well, because the above suggestions are simple to say, but they can really persevere and do There are not too many friends here, especially this patient loves sports and food.
Four years later, this patient came to the hospital again for treatment. In fact, it was not even a consultation, but for a re-examination to see if his joints were healthy. There was no improvement. When I saw this patient again, Dr. Xie didn’t dare to recognize it. Why? Because his weight has dropped significantly, it is about 160 pounds by visual inspection, and there are no obvious symptoms during the physical examination. After the MRI examination, we also saw a surprising side, although There is still a small amount of effusion in his joint, but the cartilage has not been further worn, and more importantly, the edema signal of the subchondral bone has been significantly reduced, which indicates that the pressure in the joint has decreased, and the joint The cartilage damage was significantly controlled.
The patient was carefully questioned about his symptoms. Two years ago, his joints had stopped snapping and the pain had almost disappeared, but he still insisted strictly Insist on swimming, control diet, and avoid squatting, standing, cross-legged and other actions that increase intra-articular pressure. This perseverance is really admirable.
After talking about this case, what can we learn from it is what we really need to explore.
Talk about it
Actually, the patient’s problem was more clearly diagnosed in 2018, that is, chondromalacia patella, which isThe patellar cartilage was worn out. Fortunately, the wear was not particularly severe at that time. The reason for the wear and tear of the cartilage in the joint is excessive weight is a very important factor, excessive exercise , excessive fatigue and trauma are also common causes, and there are also some conditions, such as congenital abnormal joint alignment is also a more common cause.
Cartilage is the protective layer of our joints. If the cartilage wears down, there will be problems in the bones protected by the cartilage, such as cysts, such as hyperplasia, such as edema.
We usually divide cartilage damage into 4 grades, which is more complicated. How thick is worn to make a judgment. We assume that the normal articular cartilage is the thickness of 4 fingers juxtaposed, then the thickness of each worn finger means that the damage has increased by one level. This is a comparison It is a simple method that everyone can understand. In clinical work, we often need to pass an MRI of the joint to help us observe the degree of cartilage damage, so I won’t go into details here.
As long as everyone is clear, we can determine the extent of the damage to the articular cartilage through MRI examination, and one thing, everyone must pay attention, that is, cartilage damage The less severe, the lower the level of damage, and the sooner we intervene, the better often the patient’s symptoms will recover.
So what do we do when we find cartilage damage?
●Controlling your weight is very important to reduce the irritation of the cartilage in the joints and reduce the stress on the joints.
●Use our joints reasonably, try to avoid long-term squatting, standing, excessive exercise and other behaviors, and give the joints a chance to rest.
●According to the results of MRI, if cartilage damage is not particularly serious, regular oral glucosamine can help us nourish cartilage and protect articular cartilage.
There has always been a controversy about the effectiveness of glucosamine. I personally suggest that we can try it, especially in the early stage when the symptoms of your joints are not particularly severe. Why not try it?
●If the cartilage wear is relatively obvious, regular injection of sodium hyaluronate into the joint can be used to nourish the articular cartilage, increase the viscoelasticity of the articular cartilage, and promote the damage repair.
●Hold on, hold on, hold on
In fact, it is the last one, which is especially important. It is recommended that if you have joint problems, you should not try to find a simple way, such as taking a quick-acting medicine. Or any action can help us solve the problem completely, which is unrealistic. Only by reducing the weight from the root, using the joints rationally, and choosing scientific medicine in moderation, can we really help us solve the problem, and we need to << strong>Have patience, perseverance, persevere, and we will see the effect slowly.
Like this patient, after 4 years, the edema of the subchondral bone has not completely disappeared, but We see that his problem is moving in a positive direction , I believe that after a period of re-examination, the edema may disappear, so that the patient’s problem will not further evolve into severe arthritis!
I hope this case can really give friends who have worn articular cartilage such as chondromalacia patella a booster. Let’s not be discouraged, don’t be discouraged, let alone give up, just follow the scientific method to deal with it. , Control the disease, we can do it!
I am Xie Xinhui, who insists on explaining the knowledge of complex diseases in simple language. It is not easy to code words. If you agree with my point of view, please help to follow or like it. If you Or your family and friends also have joint problems, please forward this article to them who need it, thank you!
