Cartilage defects of the shoulder


Cartilage defect shoulder, glenoid
Cartilage defect in the middle of the glenoid, just in the weight bearing area


What is a cartilage defect ?
The humeral head as well as the glenoid surface are covered by a cartilage layer. This is smooth and white and responsible for a smooth movement between both bones. If there are holes or sheared / loose cartilage areas, we are speaking about cartilage defects. It is not a complete wear of the cartilage coverage, like in arthritis or arthrosis of the shoulder. Cartilage defects are areas covering about 0.5 to 2 centimeters, normally.


What do I feel, when I am suffering from a cartilage defect ?
There is a deep pain in the shoulder often combined with a cracking or snapping. Cracking and snapping can occur with and without pain.


Development of cartilage defects:
Quite often the etiology remains unclear. Sometimes previous injuries might be the cause of it. We sometimes see bodybuilders, who use to much weight while performing benchpressing and who are performing bench pressing not correctly. Even the early stage of an arthritis / arthrosis of the shoulder joint might start as a small cartilage defects and lead to a wide wear of the shoulder joint´s cartilage.


Therapy of cartilage defects:
Operative therapy is the treatment of choice. An arthroscopy of the shoulder has to be performed. The cartilage defect is treated by microfracturing, which means that small holes are performed in the defect area. A bleeding out of theses holes is necessary so that growth factors can get to the defect zone and a secondary cartilage coverage can develop within month after this therapy.
Another therapy is a transplantation of cartilage into the defects, e.g. called ACT ( autologous chondrocyte transplantation ) or MACI ( matrix associated chondrocyte transplantation ).
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