Navy doctors seek clues to treat cartilage loss - Marine Corps News | News from Afghanistan & Iraq - Marine Corps Times

Navy doctors seek clues to treat cartilage loss

SAN DIEGO — Young troops suffering knee, shoulder and other joint injuries sometimes end up with a complete and rapid loss of cartilage, and Navy doctors are trying to find out why.

This debilitating condition, known as joint chondrolysis, can sideline or force out otherwise healthy service members.

And while it often comes from injuries with age — causing pain, arthritis and limited joint mobility — the catastrophic loss of cartilage can also occur among people as young as 20.

“We have to identify [chondrolysis] better and find ways to prevent it,” said Cmdr. (Dr.) Matthew Provencher, director of orthopedic surgery at Naval Medical Center San Diego. Unlike common cases where cartilage tears and erodes over many years, with chondrolysis “it’s more of an acute onset,” he said. “Much quicker.”

Dr. Daniel Solomon, former director of sports medicine anszd shoulder surgery at the center, said he often saw young troops complaining about pain and stiff joints. The wear and tear on cartilage may come with age, but “you shouldn’t get it in your 20s,” said Solomon, a commander in the Navy Reserve who runs an orthopedic and sports medicine center in Novato, Calif.

Provencher and Solomon recently co-authored an article in the Journal of Bone and Joint Surgery that reviewed 830 case reports on joint chondrolysis in the shoulder, knee, hip, ankle and elbow. Reasons for acute cartilage loss varied and included infection, embedded hardware, medications and surgical injury. First identified in 1930, doctors have seen many more cases of chondrolysis, mostly in younger patients. The authors hope to fill a “dearth” of analysis and ultimately develop more consistent diagnoses and treatment.

Provencher had no figures on the extent of chondrolysis among Marines and sailors but said many active-duty troops suffer injuries that could potentially lead to long-term problems.

Shoulder tears, strained biceps and injured anterior collateral ligaments in the knee, just to name a few, could lead to medical separation, especially if pain and mobility worsen. Many Marines want to return to duty before they’ve had ample time to recover, doctors said, which can worsen injury.

“We have a population that really puts itself through the paces,” Provencher said.

Dr. Anthony Romeo, a Chicago sports medicine surgeon who co-authored the article, likens service members to professional athletes.

“They are trying to use their joints to the maximum ability,” said Romeo, team physician with the Chicago Bulls and Chicago White Sox.

Provencher said he hopes to see more studies that track people over time to focus on chondrolysis, and said the military would be an “ideal” sample group.