A joint is the connection between two or more bones that is mechanically constructed to allow movement. The structure of a joint that is in good health is comprised of two main components; (a) the cartilage, which is an ultra durable and highly resilient lining of the joint that is held in place by collagen fibers and (b) the synovial fluid which is the joints lubricating system that is sheathed in a capsule which is also known as the synovial membrane.
Causes of Joint Damage
Joint damage can affect any component of the joint and it can be caused by countless injuries and innumerable accidents as well as diseases. One such disease is hemophilia which leads to joint damage due to frequent internal bleeding into the joints. However, most joint damage is the direct or indirect result of various forms of arthritis. As a matter of fact, arthritis is a general term that points to well over one hundred different medical conditions that cause pain, stiffness and inflammation in one or any number of joints in the body. The most often occurring among them are the following:
- Osteoarthritis is the inflammation of the joints due to the destruction of their cartilage and, in certain instances, the development of bony outgrowths called bone spurs.
- Rheumatoid arthritis (RA) which is a chronic inflammation of the joints and the adjoining tissues due to an abnormal separation, growth and proliferation of the white blood cells in the synovial membrane which can also lead to destruction of the joint’s cartilage.
- Systematic lupus erythematosus which is a chronic inflammation that affects not only the joints but also the skin and internal organs.
- Ankylosing spondylitis which is the condition that stiffens the spine and its surroundings.
Treatments of Joint Damage
The most common treatments for joint damage are:
1/ The surgical replacement of the damaged joint with an artificial version. This, however, is not a viable option for young patients because of the risk of wearing out the prosthetic device after approximately ten years.
2/ Cartilage has no nerve supply and, therefore, when damage begins there are no pain impulses to alert the sufferer. Furthermore, cartilage does not have the self-healing properties of the other organs of our bodies and is not expected to repair itself. To prevent an early onset of osteoarthritis, a clinical procedure to repair the cartilage is prescribed mostly to patients under the age of 40 who are experiencing pain in the knee joints due to conditions such as –
- Earlier injuries to the ligament or the meniscus of the joint in question.
- Osteochondral fractures from sports injuries.
- Chondromalacia patellae which is the spontaneous breakdown of the cartilage in adolescence.
- Osteochondritis dissecans which is a condition mostly occurring in teenagers and young adults and results in pieces of cartilage and bone separating from the surface of the joint.
- The early onset of osteoarthritis that resulted from the above conditions.
3/ Cartilage transplantation can be accomplished by four methods –
- Osteochondral grafts which include a shell of cartilage and its subchondral bone cut to size to fill the defect.
- Grafting of the cartilage without the subchondral bone and gluing it to the damaged area.
- Chondrycytes are isolated and cultured.
- Osteochondral allografts.
4/ Kogenate FS is a drug administered to the very young hemophilia patients which helps prevent or control excessive bleeding into their joints.