When Cartilage Cells 'Freeze' - Dealing with Cartilage Wear Issues

Alona, aged 52, has been suffering from knee joint pain for the past two years. She attempted to incorporate some sports activities into her busy daily routine, hoping to relieve the pressure on the joint, but without success. The pain struck her both during rest and strenuous activity. She struggled to perform simple daily tasks, and the pain troubled her even when seated, severely affecting her quality of sleep.

Chaim, 45, an educator who spends a lot of time sitting while studying and teaching, is highly aware of maintaining a healthy lifestyle and strives to keep fit to ensure the health of body and mind. Recently, he has begun experiencing knee pain following intense sports activities, and now it has become routine.

Dr. Chagai Moskovitz, an orthopedic surgeon from Medtek Israel, explains: Despite the common perception that knee problems are an issue for the elderly alone, our everyday clinical reality tells a different story. This is due to the body's metabolic process in cells. In the human body, new cells are constantly created and old cells die. Until age 30, the number of new cells produced exceeds the number of old cells that die, allowing us to grow and develop properly. At age 30, cell production slows to balance with the number of cells dying. Past fifty, significantly fewer new cells are produced, leading to wrinkles, gray hair, and more. So too in cartilage tissue, worn cartilage cells do not regenerate, and existing cells suffer from genetic defects, weight, loading, or accidents and injuries. When the treating orthopedic surgeon diagnoses cartilage wear in the knee joint, the standard treatment process is symptomatic only and tailored to each patient according to the level of cartilage damage.

Knee movement is made possible by the joint connecting two bones. The bone end is coated with flexible, transparent, and slippery cartilage. Its wear is a degenerative process, occurring mainly in heavily active joints, and those under significant stress. The space between the joint bones consists of molecules that absorb water and provide the cartilage its properties and flexibility, and fibers made of a protein called collagen produced by cartilage cells, serving as a structural skeleton and maintaining joint stability. In the wear process, cartilage cells "freeze" and cease collagen fiber production. When pressure is applied to the joint, collagen fibers wear down, and subsequently, the cartilage cells themselves are worn. Indeed, X-ray images show a narrower space between the bones in the joints.

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Cartilage wear can be caused by several factors: the first of which is the genetic structure of the joints, O-legs, and so on. The second is your routine daily activity. In cases where the regular job involves physical work that requires physical effort, the likelihood of joint damage increases, hence it is crucial to emphasize muscle strengthening and proper posture to protect the joint. Furthermore, improper sports activities can impact the joint cartilage. The third factor is accidents or injuries causing shock to the joint and affecting cartilage cell production. The last factor is chronic autoimmune diseases such as arthritis and gout, where the body attacks the joints.

Appropriate treatment for cartilage wear is adjusted to the wear degree and symptoms: For those who discover the wear early, muscle strengthening is highly recommended, such as physiotherapy, hydrotherapy, walking in shallow water, and any stabilizing physical activity. The Health Fund doctor may recommend dietary supplements containing glucosamine to thicken the joint fluid.

In the next stage, intense pain, local heat, inflammation, and swelling will appear, and treatment will be medicinal, for pain relief. This treatment is meant to address the symptom and certainly not to cure the problem. In cases of inflammation, anti-inflammatory medications can be used until the inflammation subsides. If these medications do not help, steroid treatment can be combined. A cortisone injection can help for several months, and the treatment can be repeated up to three times a year. Another solution for pain management is the injection of hyaluronic acid into the joint, a substance found in the joint fluid that lubricates the joint axis.

When cartilage wears out, it loses its smooth shape and appears rough, similar to asphalt. Therefore, in certain cases, the doctor may recommend smoothing the cartilage via an arthroscopic surgery. This is an invasive procedure whereby a small camera and tiny surgical tools are inserted through two openings in the joint to address pain-causing factors.

It is important to emphasize that the treatments mentioned above do not address the root cause of the problem. They will be effective in treating the pain arising from the issue, but the joint condition cannot improve because of them, and most of them will lead to the last resort: joint replacement surgery. This is an invasive but relatively safe surgery where the bone ends are coated with plastic or metallic implants. It is highly effective, though it demands challenging rehabilitation and recovery and is effective for about 15 years.

For those diagnosed with mild to moderate cartilage wear, there is truly promising news worth mentioning.

Around a decade ago, a unique treatment method developed and studied in Germany was introduced, even registered as a patent approved by international health organizations. It is a treatment based on magnetic resonance, similar to MRI, and implemented in health centers globally. This technology is called MBST (Multi biosignal therapy), operating with a device sending signals matching the frequency of cartilage cells, aiding in renewing cell metabolism. As a result of this method, cells regenerate collagen fibers filling the joint space anew. New collagen fiber production improves the wear degree in particular, the joint condition in general, alleviates symptoms and pain, and resolves the problem long-term. To date, an 80% success rate has been recorded. For best results, it is advisable to undergo this treatment in earlier stages of dealing with the issue, before the necessity of invasive surgery.