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Can you tell me what chondrolysis is and how they treat this problem?

Chondrolysis is the medical term for rapid destruction of articular cartilage. That's the cartilage that lines the joints and makes smooth motion possible. This is a rare condition that seems to develop following arthroscopic surgery. Eight to 12 months after the procedure, a rapid and complete loss of the articular cartilage affects both sides of the joint. The patient may not experience any symptoms at first but then pain and loss of motion develop. The symptoms advance quickly over a short period of time (four to six weeks). No one is quite sure why chondrolysis develops in some people after arthroscopic procedures. It happens after all kinds of arthroscopic operations -- not just for one type of problem. It happens in patients who have had thermal devices, suture anchors, and pain pumps put in the joint. But not everyone who have those implants develop chondrolysis, so there probably isn't just one single reason for this rapid destruction of the joint cartilage. Treatment centers around stimulating a healing response of the cartilage to save the joint, rather than remove and replace it. Joint sparing is the name given this approach. There are several ways to do this but it's a challenge because the cartilage doe not have a good blood supply to promote healing and recovery. The first (and most commonly used) procedure is called debridement. The joint is shaved and smoothed down. Any debris or loose fragments of cartilage are removed. This helps restore smooth, pain free motion. Microfracture is another method used to stimulate the cartilage to regrow. Tiny holes are drilled through the cartilage into the bone. This causes bleeding and signals a repair process to begin. Other ways to restore damaged cartilage include autologous chondrocyte implantation (ACI) and osteochondral autologous transplant (OATS). In these procedures, cartilage is placed inside the lesion in hopes of restoring the normal structure and function of the original cartilage. ACI is a new way to help restore the structural makeup of the articular cartilage. Surgeons may recommend this procedure for active, younger patients (20 to 50 years old) when the bone under the lesion hasn't been badly damaged, and when the size of the lesion is small (less than four centimeters in diameter). ACI is done in two parts. First, a short surgery is scheduled to allow the surgeon to take a few normal, healthy chondrocytes and use them to grow more in a laboratory. At a later date, the patient returns for a second surgery, at which time the surgeon implants the newly grown cartilage into the lesion and covers it with a small flap of tissue. The cover holds the cells in place while they attach themselves to the surrounding cartilage and begin to heal. With the second restorative procedure, OATS, a plug of cartilage and the first layer of (subchondral) bone are removed from normal, healthy cartilage and transferred to the site of the cartilage defect. This can be done all in one procedure and does not require two operations like the ACI. An orthopedic surgeon can evaluate your problem and make the best recommendation for treatment based on the condition of the damaged cartilage, your age, activity level, and any other risk factors that might affect treatment. If you do not have an orthopedic surgeon of your own, see your primary care physician. He or she can recommend the best way to pursue management of this problem.

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