Knee Cartilage Injury Overview
Cartilage is a connective tissue found throughout the body that lines joint surfaces. It is less rigid than bone but is stiff enough to help absorb shock placed on the joints. In the knee, cartilage provides a smooth protective layer covering the femur, tibia and undersurface of the patella. Cartilage serves as a shock-absorbing structure for the bones in the knee and provides a frictionless articulating surface.
Cartilage may be damaged by sports activities, traumatic injuries, or even work injuries. When one hears the term “loose bodies” within a joint, it refers to cartilage that has been separated from the bone and can now float within the knee. This can often be the result of an abnormal twisting motion to the joint which can occur during a traumatic injury. Daily wear and tear or prolonged stress on the knee can also lead to a knee cartilage injury. Austin, Texas orthopedic knee specialist, Dr. Jeff Padalecki specializes in the knee joint and is available to treat patients suffering from cartilage damage in the knee.
It is important to note that cartilage does not have a blood supply of its own, and therefore does not have a natural ability to heal itself when damaged. If left untreated, defects can cause further deterioration in the joint leading to the development of osteoarthritis, as well as other progressive degenerative conditions.
Knee Cartilage Injury Symptoms
The most common symptom of cartilage injuries, depending on the level of damage, is a constant, dull ache and swelling with activity. In more severe cases, a piece of the cartilage can break off and become lodged in the joint, causing the knee to lock.
Knee Cartilage Injury Diagnostic Testing
In most cases, injury to the cartilage that exists within the knee may not be immediately apparent if the patient is complaining of knee pain and or weakness. Dr. Padalecki will conduct a thorough examination of the knee and perform X-rays. If he continues to suspect a cartilage injury, then an MRI is the test of choice.
Knee Cartilage Injury Treatment
There is a grading scale on cartilage damage ranging from 0 (normal healthy cartilage) to 4 (a tear that exposes the underlying bone). The degree of the tear as determined by Dr. Padalecki and the diagnostic tests will determine the best course of treatment for the injury. It is also crucial to consider age, activity level and related injuries when trying to establish a treatment plan.
Many patients respond well to a combination of ice, rest, compression and elevation of the knee. Anti-inflammatory medications (NSAIDs) and pain relievers can be an important treatment as well. Diminished use of the knee for a period of time will help in the healing process. Physical therapy to help build back strength and mobility in the knee can be of additional assistance. Occasionally, a steroid injection may be recommended to help reduce inflammation.
There are several surgical options to repair cartilage damage. The choice of surgical treatment depends on lesion size, chronicity of injury, patient age, and patient activity level.
- Debridement – An arthroscopic procedure that smoothes or shaves down the damaged or torn cartilage and removes loose edges to prevent irritation or further shedding of cartilage debris.
- Marrow Stimulation/Microfracture – This is a procedure in which tiny holes are drilled into the bone under the cartilage which allows bone marrow cells to enter the area and form a clot.The bone marrow cells can help repair the damaged areas and replace the missing cartilage.
- Mosaicplasty – A technique in which cartilage from undamaged areas of the joint is moved to the damaged area. This procedure is not used when there is widespread damage, as in osteoarthritis.
- Allograft Transplant – A technique that replaces the damaged areas cartilage with a cartilage-bone unit that is procured from a donor. This is usually reserved for large areas of cartilage damage and can be ideal in situations where the underlying bone is damaged.
- Autologous Chondrocyte Implantation (ACI) – During this procedure, a small piece of cartilage is removed and sent to a laboratory where additional cartilage cells are fostered from the sample. After a period of waiting, the new cartilage cells are implanted into the knee by injecting the cartilage cells into the defect. These cells eventually grow into new cartilage.
It is crucial that patients follow the rehabilitation schedule and protocol as set forth by Dr. Padalecki. This often includes a period of non-weight bearing with crutches to help protect the knee while new cartilage grows. Physical therapy usually begins promptly so that range of motion can be regained. A continuous passive motion device is often used to help move the knee in the early weeks following surgery.
For more information on cartilage damage to the knee, or additional details on knee cartilage injury treatment options, please contact the office of Dr. Jeff Padalecki, orthopedic knee specialist in Austin, Texas.