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You expect your joints to be flexible with a full range of motion to take you through all your daily activities. But do you know what helps your joints stay flexible so you can enjoy movement without pain and stiffness? It's cartilage, the slick, rubbery connective tissue that covers the joint surfaces, reducing friction between the bones that make up your joints so joint motions remain fluid and pain-free.

Just like any other tissue, cartilage is bound to break down over time, sometimes as a result of age-related changes and sometimes due to the repeated strains and everyday wear and tear they're subjected to. And as cartilage begins to wear away, the friction inside your joints increases, along with pain, stiffness and eventually, decreased range of motion and mobility.

Joint cartilage has a very limited blood supply compared to other types of connective tissue, limiting the tissue's ability to repair itself, especially when the joint is under constant use. Until recently, the only way to treat damaged shoulder cartilage was with physical therapy, rest, and oral and injected medications, along with some other injectable products designed to provide additional lubrication inside the joint. But in more recent years, medical researchers have been looking at ways to restore shoulder cartilage with grafts and surgical techniques designed to create areas of “controlled damage” designed to stimulate the body's natural healing responses, including the formation of new, healthy cartilage. For many patients, these techniques bring relief of chronic pain and shoulder joint dysfunction, helping patients return to a more active lifestyle, delaying the onset of arthritis and even postponing the need for joint replacement surgery.

How does shoulder cartilage become damaged?

In the shoulder, cartilage protects the end of the upper arm bone (the humerus) as well as the internal surface of the joint, called the glenoid cavity. These two structures comprise a ball-and-socket joint that can move in many different directions. When the protective cartilage inside the joint begins to wear away and break down, it can result in significant pain when reaching upward or behind your back, lifting objects, reaching across your body, or moving your arm in an arcing motion.

Osteoarthritis is the most common cause of cartilage damage in the shoulder, becoming more prevalent with age and with repetitive use of the joint. Arthritis is also more likely to occur if you've had a previous shoulder injury. Cartilage damage in your shoulder can prevent you from participating in many types of sports like tennis, volleyball and swimming, and it can even interfere with normal daily activities.

How does shoulder cartilage replacement & restoration work?

There are several minimally-invasive techniques that can be used to restore damaged joint cartilage including shoulder surgery and arthroscopy. The technique that's used in your case will depend on several factors, including the cause and extent of the joint damage, your overall health, your lifestyle and other factors.

  • Arthroscopic surgical techniques can be used to access the joint through tiny incisions, removing torn cartilage and other debris and repairing damaged cartilage to help restore normal joint function.
  • Microfracture uses very small holes drilled into the surface of the bones that comprise a joint to stimulate and “jumpstart” natural cartilage formation.
  • Osteochrondral transfer uses healthy cartilage grafts derived from the patient's own body, transplanting the grafts into the area where joint damage has occurred.
  • Autologous chondrocyte implantation (MACI) is a two-step procedure that begins by harvesting healthy cartilage cells from the patient's body. Those cells are grown in the lab, forming new cartilage tissue that is then implanted into the areas where cartilage is damaged.
  • Osteochondrial allografts typically are reserved for larger areas of damage and rely on donor cartilage grafts to repair and restore joint surfaces.

Which technique is right for me?

Shoulder cartilage restoration can be an excellent choice for many people with osteoarthritis and other types of joint surface damage, but it's not always the best option. To find out if cartilage restoration can help relieve pain and stiffness in your shoulder and help you get back to the activities you love, call Dr. Van Thiel with OrthoIllinois at and schedule a consultation today.

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