Joint surfaces are covered with a thin layer of articular cartilage. This layer acts as a lubricant and shock absorber. As damage occurs, this structure wears away and pain results. The bone itself is below the articular surface. As the articular cartilage becomes deformed and thin, resultant damage and irreversible changes occur to the supporting bone. Patients with articular cartilage damage will complain of pain, loss of motion, swelling, weather-related changes, and loss of function. Management consists initially of limiting stress on the joint and mild medication. If symptoms progress, steroidal injections to the joint may temporarily or permanently relieve symptoms though focus needs to be on eliminating or reducing the forces that caused or could exacerbate the condition. Heavy lifting is contraindicated for such patients as it can undo the benefit of treatment, especially targeted steroidal injections. However, due to the potential deleterious effects of steroids, there are limits, in quantity and frequency, to steroidal injections. If the foregoing fail, end-stage treatment is replacement of the joint itself with a surgical reconstruction (joint replacement where the damaged bone is cut away and replaced with metal and plastic).
Articular cartilage damage medical expert witness specialties include orthopaedic surgery, rheumatology, foot and ankle orthopaedic surgery, endocrinology, orthopaedic supine surgery, neurosurgery, and hand surgery.