Abstract
Introduction: Articular cartilage damage is a major cause of pain and functional disability which can occur as a result of injury, disease process such as osteoarthritis, or both. While surgical approaches may provide definitive treatment, they are not typically indicated for mild to moderate damage, may be contraindicated in patients with risk factor, and carry a risk of both operative and anesthetic complications. Nonoperative care may not be definitive in advanced cases, however it can provided definitive treatment in more mild to moderate disease. When excluding biologic options, nonoperative treatments do not reverse the disease process or damage, however there are a variety of options which have been shown to provide significant improvement in terms of pain and function, and many treatments delay and can potentially stall progression of articular cartilage damage. In this chapter, we provide an evidence based approach to the various nonoperative options for the treatment of articular cartilage disease, including exercise, weight loss, physical therapy, braces, oral medications, topical medications, supplements, corticosteroid injections, viscosupplementation, and prolotherapy.
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