Ask the Doctors: Cartilage loss increases joint friction

Cartilage can also sustain physical injury. Twisting a joint can result in damage. So can the force and impact common in sports.

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To slow cartilage loss, you want to reduce stress on the joint. That means limiting repetitive and high-impact activities.

To slow cartilage loss, you want to reduce stress on the joint. That means limiting repetitive and high-impact activities.

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Dear Doctors: I am a 77-year-old woman diagnosed by my orthopedist with reduced cartilage in my right knee, probably due to wear and tear and arthritis. I’m not in pain, but I have developed bone spurs, and there is some swelling. What can I do?

Answer: Cartilage is a remarkable tissue that reduces friction, acts as a shock absorber, enhances strength, provides structure and augments flexibility.

There are three types of cartilage. Elastic cartilage, which is in the outer ear and larynx, provides shape and elasticity. Fibrocartilage, tough and strong, is in joint capsules, ligaments and the spine’s invertebral discs.

In the joints, that’s hyaline cartilage. Smooth to the touch and a pale bluish-white, it’s the most abundant type of cartilage.

Hyaline cartilage caps the ends of bones and lines the inner surfaces of joint capsules. Its smooth surface, with an assist from specialized fluids, makes it possible for bones to meet and glide almost frictionless against one another — almost.

Over time, though, wear and tear take a toll.

Twisting a joint can result in cartilage damage. So can the force and impact common in sports. Ongoing inflammation from autoimmune conditions can, too. Because cartilage lacks an active blood supply, it’s slow to heal.

When cartilage wears away, bone spurs often occur. These bony lumps on the surface of joints are a response as the body strives to maintain stability in the knee. Bone spurs don’t hurt. But they can limit range of motion and press or rub against neighboring tissue, causing pain.

To slow cartilage loss, you want to reduce stress on the joint. That means limiting repetitive and high-impact activities that require the knee to be a shock-absorber, which can damage the connective tissues of the joint.

Instead of high heels, which increase stress on the knee, wear shoes that are soft and flexible, with a flat or low heel.

It’s important to reach and maintain a healthy weight. Studies have shown being overweight, which stresses the joints, can contribute to cartilage loss.

You’ll want to manage inflammation. Your doctor might recommend nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen to lessen swelling and can help ease pain.

For swelling, injections might be recommended. Steroids can help inflammation and swelling. Hyaluronic acid, which occurs naturally in joint fluids, can aid lubrication. Platelet-rich plasma, derived from your blood, can aid healing. Your doctor can advise whether any of these might help you.

Dr. Eve Glazier and Dr. Elizabeth Ko are internists at UCLA Health.

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