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Does articular cartilage heal?
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Does articular cartilage heal?

Hello,

I am a 20-year old male bodybuilder.

Two months ago, I injured my knee while squatting. After seeing an orthopedic surgeon and getting an MRI, I was diagnosed with articular cartilage damage (Grade 2, bordering Grade 3). According to the surgeon, the damage was not all the way to the bone and is located underneath the knee cap. He said that I do not need surgery and just need to wait for it to go away.

It's been two months since the injury. The pain has gotten less indeed. However, after reading articles about articular cartilage, I understand that articular cartilage has limited ability for healing, escpecially if its not all the way to the bone (Grade 4).

Although the surgeon said "no surgery needed", I still don't undertand how things would get better...
How could my grade 2 defect possibly heal, since it is not all the way to the bone?

Thank You
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Avatar_dr_m_tn
Hi, it is sad to hear that you damaged the cartilage and secondly you require body building, which could be difficult with a damaged cartilage. Articular cartilage doesn't have a blood supply and therefore it has a capacity for healing. In general, partial thickness defects do not heal by themselves. In addition to not having a blood supply articular cartilage also has no nerve supply. This is in contrast to the bone immediately below the cartilage which is abundantly supplied with both nerves and blood. If the articular cartilage damage is shallow (grades 1 or 2) you may not experience any pain from the defect at this stage as the sensitive nerve endings in the subchondral bone are still covered with some articular cartilage. As you had pain with the damage that means the injury also damaged some nerves beneath the cartilage. The damage to nerves and subchondral bone can start a healing process in the defect. This result in the formation of scar tissue made up of a type of cartilage called fibrocartilage. This looks like dense cartilage but functionally it is not strong enough.
Similarly if surgery is done then the gap can be filled and repir can be done to get a scar tissue or fibrocartilage but functionality can’t be restored to 100%. Thats why the surgeon choose to not to do surgery unless absolutely required. You need a precise advice from your doctor about the limit of activity you may be able to do after healing. Regards
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1524655_tn?1291424132
Dr. Arora,

Thank you for your advice. I do experience pain in the knee, especially when walkng up and down the stairs. So, does that mean that there is a healing process going on? How long does this injury take to heal? Will the pain ever go away and will I ever be able to return to bodybuilding (training quads in particular)?

Thank You
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