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Effective articular cartilage repair in athletes depends on patient, injury characteristics

Issue: June 2012

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MONTREAL — Though function and athletic activity have been shown to improve after articular cartilage repair, a researcher speaking at the International Cartilage Repair Society World Congress 2012, noted that long-term studies are still needed to determine whether such repair can effectively prevent arthritic degeneration and reverse chondropenia.

According to Kai Mithoefer, MD, while certain repair techniques have yielded improved function and athletic activity, results are dependent on several factors and the technique used must be tailored to the specific characteristics of the patient and the injury.

“There is an acute injury pathway and a chronic injury pathway,” Mithoefer, of Chestnut Hill, Mass., said.

 

Kai Mithoefer

During his talk, Mithoefer noted research has shown that regardless of whethe an ACL injury is treated operatively, there is an increased risk of cartilage loss with time, increasing significantly after 7 years to 11 years. One of the relevant factors associated with this increased risk is size of the bone bruise at the time of injury, he added.

According to Mithoefer, chronic cartilage injury factors include instability, malalignment and impact loading.

“What is the best prevention? Should we just not play sports? Should we not play impact sports? I do not think that is the solution,” Mithoefer said.

Mithoefer noted that treating concomitant issues such as meniscal injury or malalignment is vital in effective, durable articular cartilage repair, pointing out that data indicates that additional procedures do not have a significant negative impact on the ability of patients to return to play.

“The general treatment strategy for athletes should be not only to reduce pain, but also to restore joint function as a whole organ, not just the cartilage, the ligaments or the muscle,” he said. “This can be a challenge … there is still a lot of work to do.”

Reference:

• Mithoefer K. Cartilage problems in the athlete: The scope of the problem. Paper #1.3. Presented at the International Cartilage Repair Society World Congress 2012. May 12-15. Montreal.