Damaged Cartilage and Osteoarthritis of the Knee: Pain Relief and Therapy

Damaged Cartilage and Osteoarthritis of the Knee: Pain Relief and Therapy

Pain when walking down stairs or hills… pain after exercise… pain when getting up after long periods of sitting: Knee pain is a typical symptom of cartilage damage or osteoarthritis of the knee.

In this article, Dr. Gäbler from the SPORTambulatorium Wien summarizes various osteoarthritis therapies and explains why early treatment is so important when there is wear and tear on the joints.

Schmerzen beim Bergabgehen, nach Belastung oder sogenannte Anlaufschmerzen beim Aufstehen nach längerem Sitzen: Knieschmerzen sind typische Symptome für Knorpelschäden oder eine Arthrose im Knie.

Table of Contents

  1. What is osteoarthritis of the knee?
  2. Osteoarthritis of the knee: Diagnosis and therapy
  3. Types of cartilage damage and means of therapy
    1. Chondromalacia patellae (softening and deterioration of kneecap cartilage)
    2. Articular surfaces of the femoral condyles
      1. Microfractures
      2. Mosaicplasty
      3. Knorpeltransplantat (MACT)
      4. AutoCart Knorpeltransplantat (MINCED CARTILAGE)
      5. Cartilage Smoothing
      6. Eigenblut Infiltrationen (ACP)
      7. Cingal Gel Spritze – Hochvernetzte Hyaluronsäure
  4. Medication for joint pain and damaged knee cartilage
  5. Other dietary supplements for osteoarthritis therapy
  6. Osteoarthritis of the knee: Reducing pain with early treatment 

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What is osteoarthritis of the knee?

Osteoarthritis of the knee can be very painful. It occurs when the joint cartilage is irreparably damaged.

Cartilage damage can occur due to an acute event or through chronic stress and is a common cause of persistent pain, especially during initial exertion. Cartilage damage often begins with a softening of the cartilage (chondromalacia). Over time, this type of pain is even present after prolonged sitting. When cartilage damage or wear becomes widespread, it is called osteoarthritis. Left untreated, cartilage becomes brittle and can fray or break off. Once cartilage has broken off and the bone surface is exposed, patients usually experience severe pain during knee exertion.

Osteoarthritis of the knee: Diagnosis and therapy

Cartilage damage can occur on the kneecap or on the joint surfaces (femoral condyles, upper extremity of the tibia). Depending on the cause and extent of cartilage damage, there are two basic therapeutic approaches:

1) Eliminate the cause

  • Insoles 
  • Physical therapy
  • Repositioning surgery 

2) Treat the knee joint directly

  • Dietary supplements
  • Platelet-rich plasma (PRP) or hyaluronic acid injections
  • Microfractures

Häufige Probleme:


Please note that the nutritional supplements and medication listed here may or may not help relieve your symptoms. A good rule is: Try and see. Current research indicates that all of these substances are harmless.

Knorpelpräparat Sportambulatorium

Täglich sehen wir PatientInnen, die an Arthrose bedingten Gelenkbeschwerden leiden. Die betroffenen Gelenke sind in ihrer Beweglichkeit und Belastbarkeit eingeschränkt. Eine Operation ist hier oft nicht erforderlich, denn eine konservative Behandlung kann durchwegs auch zu einer Verbesserung der Schmerzsymptomatik führen. Neben Physiotherapie, einer Ernährungsumstellung und gelenkschonender Aktivität gibt es ernährungsergänzende Präparate, die nachgewiesenerweise Gelenkprobleme deutlich verbessern können.

Es gibt zahlreiche Substanzen am Markt. Da wir aber mit dem Angebot nicht vorbehaltlos glücklich sind, bietet das Sportambulatorium ab sofort neu- und weiterentwickelte Knorpelaufbauprodukte und Vitaminpräparate für seine PatientInnen an.

Kollagen Typ II & Natriumhyaluronatsäure & Ascorbinsäure & Kupfergluconat Präparat

Das Kombinationspräparat aus Kollagen Typ II und Natriumhyaluronsäure unterstützt die Regenerierung des Knorpels. Neueste Studien zeigen, dass sich hochdosiertes Kollagen Typ II bei Knorpeldefekten im Knorpel einbaut, es dadurch zu einer Versiegelung des Knorpels kommt und sich eine verbesserte Oberfläche bildet.

Der zweite wichtige Bestandteil in diesem Präparat ist die Hyaluronsäure. Dabei handelt es sich um eine Substanz, die die Gleitfähigkeit der Gelenke verbessert. Meist wird die Hyaluronsäure in das Gelenk gespritzt. Die orale Einnahme ist allerdings eine perfekte Alternative. Obwohl es etwas länger dauert, bis die Wirkung einsetzt, hat man den Vorteil, dass die Hyaluronsäure in allen Gelenken wirkt, nicht nur z.B. in dem infiltrierten Knie. Außerdem vermeidet man mögliche Komplikationen, die im Rahmen einer Infiltration auftreten können.

Glucosaminsulfat & Chondroitinsulfat & MSM Präparat

Bei Glucosaminsulfat und Chondroitinsulfat handelt es sich um Substanzen, die nachgewiesenerweise zur Stabilisierung der Grundsubstanz des Knorpels und zur Knorpelregeneration führen. Die Substanz MSM hilft vor allem bei Patienten mit beginnender, aber auch fortgeschrittener Arthrose ausgezeichnet. MSM hat eine entzündungshemmende Wirkung und kann dadurch fortschreitende Arthrose verlangsamen respektive stoppen. 

Was unterscheidet uns von anderen Produkten am Markt?

Die jahrelange Erfahrung von Prof. Dr. Gäbler, sowie das Einbringen neuester wissenschaftlicher Erkenntnisse, führten zu einer weitaus verbesserten Zusammensetzung unserer Präparate. Unsere Knorpelaufbaupräparate enthalten die wichtigsten Substanzen, die der Knorpel zur Regeneration benötigt, in einer sehr reinen und hochdosierten Form. Da viele Patienten Brauseprodukte weniger gut vertragen, sind all unsere Präparate in Kapselform erhältlich.

Other dietary supplements for osteoarthritis therapy

CONDROSULF (chondroitin sulfate)

In order to ensure an effective protective glide between your bones, cartilage contains many different substances. It consists of cells and a basic matrix produced by the cartilage cells. One of the primary components of the cartilage matrix is chondroitin sulfate, which inhibits the activity of proteins (enzymes) that break down cartilage.

Taking chondroitin sulfate is said to promote the synthesis of a new cartilage matrix, making the cartilage more resistant. Chondroitin sulfate is a natural product and, like hyaluronic acid, is harvested from animal sources, either from fish (Condrosulf®) or poultry (Structum®).

Both supplements are usually taken over a period of about 3 months, once or twice a year. In order for treatment with chondroitin sulfate to be effective, there must be reactive cartilage present. For this reason, these supplements are primarily used in the early stages of osteoarthritis, as well as for growth-related knee pain in adolescents.

As the effects of chondroitin alone are usually minimal, it is important to choose a combination supplement that also contains glucosamine and collagen II.


Healthy cartilage needs a dense network of collagen fibers for internal stabilization and nutrient transport as well as a dense matrix, which is mainly composed of glucosamines. Athletes, people in professions with high joint stress, and patients undergoing rehabilitation and regrowth all have an increased need for collagen.

Dietary collagen supplements should provide the body with the amino acids needed to build up collagen. In animal experiments, a study using radioactively marked hydrolyzed collagen found that collagen fragments were indeed actually incorporated into the cartilage.

Other studies found that patients with mild osteoarthritis who were treated with hydrolyzed collagen reported improved joint mobility and pain relief after about 4-6 weeks. However, these effects have not been scientifically proven in double-blind studies.

Dietary supplements with hydrolyzed collagen are available in drugstores and pharmacies in pill and powder form.


Glucosamine is an essential component of proteoglycans (glucosaminoglycans), proteins that bind water in cartilage tissue to ensure that impacts are minimized.

An important component of synovial fluid, glucosaminoglycans ensure viscosity, maintain the joints’ gliding ability, support the supply of nutrients to joint tissue, and thus play an essential role in maintaining and regenerating cartilage tissue. Glucosaminoglycans also support the growth and structure of our connective tissue.

Glucosamine is taken in the form of glucosamine sulfate. There are now a number of combination supplements on the market that contain chondroitin sulfate and glucosamine sulfate, meaning that you only have to take one pill. Glucosamine can also be taken as green-lipped mussel extract instead of in pill form. (Young dogs are often given green-lipped mussel extract to build up their cartilage, but it is also highly valued by runners.)


How green-lipped mussel extract works: In addition to vitamins, minerals, and trace elements, green-lipped mussels also contain many amino acids and a high level of sugar-like substances called glucosaminoglycans (see above for more about their effects). In addition to maintaining and building up synovial fluid and connective tissue, there is another relevant aspect to the treatment of rheumatic diseases: the anti-inflammatory effects of the extract. This is attributed to the fact that green-lipped mussel extract contains omega-3 fatty acids, which inhibit the synthesis of prostaglandins from arachidonic acid, thus counteracting the inflammatory processes.

Many runners swear by green-lipped mussel extract for nonspecific joint pain and diffuse cartilage damage. However, these effects have not been scientifically proven in double-blind studies.


The abundant silica contained in this supplement supports both the body’s own production of collagen and also matrix production (encouraging glucosamine formation). The combination of horsetail concentrate together with hydrolyzed collagen is said to be particularly successful. Here, too, effects have not been verified by double-blind studies.


Da die Regeneration eines bereits geschädigten Kniegelenkknorpels nicht möglich ist, kann eine Behandlung von Arthrose immer nur symptomatisch erfolgen. Gelenkerhaltenden Arthrose-Therapien wie Eigenblut-Infiltrationen oder die medikamentöse Therapie mittels Nahrungsergänzungsmitteln können die Kniefunktion erhalten oder verbessern sowie die Schmerzen am Knie minimieren

If your knee osteoarthritis requires surgical treatment, your doctor will recommend the most suitable method for your specific case (cartilage regeneration, microfractures, Pridie drilling, mosaicplasty, cartilage transplantation, or MPFL reconstruction) following a personal discussion.

The knee specialists at the SPORTambulatorium Wien, directed by experienced knee surgeon Dr. Gäbler, look forward to meeting you during your appointment, which can be scheduled online or by phone at 01 4021000.

More information on knee osteoarthritis

>> Interview with Dr. Gäbler on osteoarthritis | vielgesundheit.at (German only)

>> Dr. Gäbler on the topic of knee injuries in sports | Kurier article 08/2010 (German only)

More questions?

Our experts are happy to help you

Just give us a call!

Please note that medical indications and therapies are constantly changing and evolving. Sometimes these changes occur more rapidly than Dr. Gäbler is able to update the homepage. Detailed information about the dosage, administration, and composition of medications may have changed since the last update. Reading a website is never a substitute for visiting your doctor. An examination by and discussion with your doctor can provide significant additional information for you based on your personal diagnosis and the latest scientific findings. Please note that surgeries and outpatient procedures are not performed on the premises of the Sportambulatorium Wien.