“Cartilage Ailments in Sportspeople: The State of the art”. This is the title of the Lectio Magistralis Doctor Cristiano Sconza, a specialist in Orthopedic and Neuromotor Rehabilitation at Humanitas, delivered during a convention about Sports Medicine in the city of Prato.
This work also involved Doctor Ilaria Marchetti, sports doctor, and Doctor Stefano Respizzi, deputy director of Rehabilitation and Functional Recovery at Humanitas.
“First of all, we spoke about the properties of the articular cartilage, explaining how it reacts to stress during a walk or a running session”, Doctor Sconza says.
Chondromalacias of Knees
“Then, we focused on chondromalacias, that are the ailments of the cartilage, paying particular attention to those who affect knees. This is a really important topic. More than 90% of the NBA athletes suffer from cartilage issues, diagnosed during MRIs to their knees for other reasons.
The most relevant problem is the fact that the regeneration of the cartilage is very difficult because it is a non-vascular component.
There are two different types of lesion. The focal ones and the spread ones. The first affect mainly young people and depend generally on a severe trauma. In the majority of cases, they require a surgical operation. The second group depends on repeated microtraumas and mainly affects athletes in their 30s or older patients”, the specialist points out.
The role of a Conservative Treatment
The treatment may be conservative or surgical. Conservative treatments are recommended to patients who are not professional athletes who have a small focal cartilage lesion or a spread light-to-moderate degenerative situation. Instead, surgical treatment is recommended to professional athletes and young people with high functional needs.
“The conservative treatment makes use of many techniques, such as pain management, weight control (in fact, being overweight overloads the knee), physical-kinesthetic therapy, visco-supplementation with interarticular hyaluronic acid infiltrations, slow acting drugs, and orally administered supplements. Nowadays doctors are also really keen on the use (via interarticular infiltrations) of local growth factors, such as platelet-rich plasma (PRP). The field of Regenerative Medicine is developing rapidly thanks to the efforts of Professor Elizaveta Kon. She is one of the foremost experts in this field and Supervisor of Translational Orthopedy at Humanitas”, Doctor Sconza points out.
Post-surgical Rehabilitation
The physiatrist also cares for the planning of the rehabilitative treatment of patients after a surgery. In this case, the recovery consists in:
- inflammation management
- mobility and muscular elasticity recovery
- strength and resistance recovery
- proprioception recovery
- neuromotor recovery
- gradual return to sports
The recovery time is different for each patient and also depends on the surgical technique. Then, remember that we base on functional criteria, not on temporal ones. Patients will completely heal only when they are able to perform at their best their daily and sporting activities.
