Cartilage defects in the knee involve damage to the articular cartilage, which covers the ends of the bones to prevent them from rubbing together. These defects may be degenerative, resulting from wear and tear, or traumatic, caused by injuries such as falling on the knee, jumping down, or rapidly changing directions during sports activities. Since cartilage lacks nerves, these injuries may not cause immediate symptoms, but over time, they can disrupt normal joint function, leading to pain, inflammation, a grinding sensation in the knee, and limited mobility.

Cartilage damage can range from a soft spot on the cartilage to a small tear in its surface, to an extensive tear reaching the bone. This damage may worsen over time and cause additional joint problems. As cartilage does not have a blood supply, the body cannot typically repair such defects naturally. However, in cases where the bone is also injured, scar tissue (fibrocartilage) may form, which replaces the missing articular cartilage but does not provide the same smooth gliding surface for fluid movement.

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Diagnosis of Cartilage Defects

To diagnose a knee cartilage defect, the doctor will begin with a medical history and a physical examination. Imaging tests, such as X-rays, MRI, and CT scans, help the doctor assess the tissue and bone inside the knee to determine the cause of pain and dysfunction.

Treatment of Cartilage Defects

Treatment options for cartilage defects vary depending on the location, severity, and degree of damage, as well as the age and activity level of the patient. In most cases, surgical intervention is required to relieve pain and improve joint function.

Debridement

For older patients with smaller defects and mild symptoms, debridement may be an appropriate treatment. This is an arthroscopic procedure in which small incisions are made to insert a camera and instruments. Damaged tissue is removed, offering some relief, though the underlying defect is typically not repaired during this procedure.

Microfracture

Microfracture is another arthroscopic procedure used to repair knee cartilage. During the procedure, a small surgical tool creates tiny holes, or microfractures, in the bone near the cartilage defect. This stimulates the release of cells that produce cartilage, helping to rebuild the damaged area over time.

Osteochondral Autograft Transplantation (OATS)

In the OATS procedure, healthy cartilage from a non-weight-bearing area of the knee is harvested and transplanted to the damaged site. This procedure is generally used for smaller defects and helps fill the cartilage holes with healthy tissue from the patient’s own knee.

Autologous Chondrocyte Implantation

Autologous Chondrocyte Implantation involves harvesting a sample of healthy cartilage, growing it outside the body in large quantities, and then re-implanting it onto the damaged area of the knee. The newly grown cartilage helps protect and support the bone, aiding in the healing process.

Conservative Treatments

For cases with mild cartilage damage, more conservative treatments may be sufficient to alleviate symptoms. These treatments can include:

  • Resting the knee
  • Wearing a brace
  • Taking non-steroidal anti-inflammatory drugs (NSAIDs)
  • Receiving corticosteroid injections

In severe cases, however, surgical intervention may be required to restore joint function and reduce pain.

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