Articular cartilage is a firm, rubbery material that covers the ends of bones in the knee joint. It reduces friction in the joint and acts as a “shock absorber.” When cartilage becomes damaged or deteriorates, it limits the knee’s normal movement and can cause significant pain. If damaged cartilage is not treated appropriately, it can worsen and eventually require knee replacement surgery.
It can become damaged as a result of an injury due to sports or accidental injuries, or could be wear and tear – osteoarthritis
Symptoms of cartilage damage
- joint pain – this may continue even when resting and worsen when you put weight on the joint
- swelling – this may not develop for a few hours or days
- clicking or grinding sensation
- joint locking, catching, or giving way
Conservative in minor injuries in the form of rest, ice packs, compression dressings, immobilisations for short periods and elevation along with pain killers
This is followed by aggressive rehabilitation.
- For larger injuries,
- Young and active individuals,
- Failed conservative treatment.
A number of surgical techniques can be used, including:
Surgery is done most often with arthroscope [key hole], and occasionally require larger incisions too.
lavage and debridement [chondroplasty] – the joint is cleaned out to remove any loose tissue, and the edges of the damaged area are trimmed to make them smooth
marrow stimulation [microfracture] – tiny holes are made in the bone beneath the damaged cartilage, which releases bone marrow into it; the marrow cells then begin to stimulate the production of new cartilage
mosaicplasty – small plugs of healthy cartilage from non-weightbearing areas of a joint, such as the side of the knee, are removed and used to replace small areas of damaged cartilage
osteotomy – the alignment of the leg is altered slightly to reduce pressure on the damaged area and improve pain; this usually involves adding or removing a wedge of bone from the shin or thigh bone, and the bone is fixed with a plate until it heals
autologous chondrocyte implantation [ACI] – the surgeon first takes a small sample of cartilage cells from the joint; these are then used to grow more cells in a laboratory and the new cells are used to replace the damaged cartilage
joint replacement – replacing the whole joint with an artificial joint, such as a knee replacement or hip replacement, is occasionally necessary if the damage is particularly severe
Surgical choices will be made by the surgeon depending on the defect size, location, activity levels and age of the patient.