Symptoms of Articular Cartilage Damage
The symptoms of a chondral injury resulting from articular cartilage damage will not present themselves as prominently as a torn ACL or meniscus tear. Similar to other arthritic conditions, the symptoms start mild and continue to progress as time goes on.
Symptoms with damaged articular knee cartilage, include:
- Intermittent swelling (often the only symptom)
- Pain associated with prolonged walking or stair climbing
- Buckling or giving way when full weight is placed on the knee
- Locking or catching
- The knee may make noise during motion
Diagnosing a chondral injury can be difficult. Many times, a swollen knee will show a normal exam. Imaging using an X-ray, MRI or via an arthroscopic examination can help determine if cartilage loss is occurring, thus leaving a decrease in space between the bone surfaces.
Treatment for Chondral Knee Injuries
Articular cartilage degeneration is often treated without surgery. Dr. Millett will recommend exercises to strengthen the muscles around the joint, supplements and possibly injections of regenerative medicine, such as PRP (platelet rich plasma) or hyaluronic acid, to improve joint lubrication and reduce friction. There are medications that can be prescribed to help treat symptoms associated with chondral injuries. However, since new growth of cartilage is challenging, most medications presently will not cure the condition. Medications and other treatments however can allow patients to live pain-free and remain active.
Over the past decade, there have been big strides and exciting advancements in the surgical treatment of articular cartilage defects. The most commonly performed procedures for treating chondral defects include chondroplasty (cartilage removal), microfracture (holes made in bones that release stem cells from the marrow), and OATS, or OsteoArticular Transfer – this can be done by taking a piece of bone and cartilage from elsewhere in one’s knee or from a cadaver knee and then transplanting it into the defective area.
Chondroplasty – Shaving or Debridement
This arthroscopic surgery technique uses special arthroscopic instruments to smooth the shredded or frayed articular cartilage. Ideally, this treatment will decrease friction and irritation, reducing the symptoms of swelling, noise, and pain.
This arthroscopic technique encourages the growth of new cartilage into the defect. This is a well-accepted technique that is a common procedure for patients with damage through the full thickness of articular cartilage (all the way to the bone).
OATS, osteochondral autograft transfer system, is a technique that involves replacing damaged joint cartilage (in high weight bearing areas) with healthy cartilage and bone (from lower weight bearing areas). This is an arthroscopic or open procedure done using either one’s own healthy tissue or tissue transplanted from a cadaver. Small holes are drilled into the damaged cartilage area. Then, bone and cartilage grafts are inserted into the defective area to re-surface the damaged cartilage. It is highly effective.