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KNEE INJURIES CAN LEAD TO KNEE REPLACEMENT
Many doctors fail to appreciate the seriousness of bleeding into the knee joint caused by a football, soccer, automobile or any other injury.
Studies at Utrecht Medical Center in the Netherlands show that culturing cartilage with blood cells in a petri dish causes profound and permanent damage to the cartilage. That means that a young person who is hit on his knee during a football or soccer game and has swelling from bleeding into the joint can almost always expect permanent damage.
All people with knee swelling caused by trauma should be checked by an orthopedist. If they have a complete tear of a ligament, they need surgery to replace the ligament and stabilize the knee to prevent further damage. If cartilage is broken, they should be told that broken cartilage never heals and that running and jumping will shear off more cartilage. They should avoid sports that require running and jumping and take up cycling and swimming because they do not jar the knee and help strengthen the muscles that stabilize and protect the knee.
G Roosendaal, ME Vianen, JJM Marx, HM vandenBerg, FPJG Lafeber, JWJ Bijlsma. Blood-induced joint damage - A human in vitro study. Arthritis and Rheumatism, 1999, Vol 42, Iss 5, pp 1025-1032.Objective, To investigate mechanisms underlying cartilage damage caused by brief exposure of cartilage to blood, such as that occurring during intraarticular bleeding. Methods. Human articular cartilage was cultured for 4 days in the presence of blood (components; 7.5-50% volume/volume). The synthesis of cartilage matrix, as determined by proteoglycan synthesis (incorporation of (SO42-)-S-35), was measured directly after exposure and after a recovery period of 20 days, during which the cartilage was cultured in the absence of blood or blood components. The production of the cytokines interleukin-1 (IL-1) and tumor necrosis factor alpha (TNF alpha), which have a destructive effect on cartilage, was determined by enzyme-linked immunosorbent assay, and the viability of chondrocytes was determined by measuring lactate dehydrogenase release and with electron microscopy, The involvement of oxygen metabolites was evaluated by using N-acetylcysteine. Results. Brief exposure to blood resulted in dose-dependent inhibition of proteoglycan synthesis. The combination of mononuclear cells and red blood cells was responsible for this effect. The effect was irreversible, independent of IL-1 and TNF alpha production, and was accompanied by chondrocyte death. These effects were partially prevented by N-acetylcysteine, Conclusion, Brief exposure of cartilage to blood, as occurs after a single episode or a limited number of bleeding episodes, results in lasting cartilage damage in vitro, in which cytotoxic oxygen metabolites play a role.
Checked 8/31/05