Knee Cartilage Injuries

Knee injuries often involve damage to the cartilage, a critical component that cushions and supports the joint. Cartilage injuries can vary from minor tears to more severe conditions requiring surgical intervention.

The knee joint is composed of articular cartilage, which provides a smooth surface for easy movement between bones, and meniscus cartilage, which acts as a shock absorber during weight-bearing activities.

Knee cartilage injuries are among the most common orthopaedic knee injuries that sports medicine specialists treat and can occur in nearly 25-40% of athletes. These injuries can cause significant disability resulting in missed time from school, sports, and occupational activities. While the majority of injuries respond to an initial course of non-surgical management, many will require more advanced surgical techniques to restore function.

Types of Knee Cartilage Injuries

1. Articular Cartilage Injury:
   • Causes: Can occur from normal use of the joint, congenital or developmental abnormalities during adolescence, and from trauma or overuse.
   • Symptoms: Dull pain, swelling, and stiffness, especially during activities like climbing stairs.
   • Diagnosis: Physical examination may demonstrate joint swelling, tenderness along the joint and in some instances, restriction in range of motion. X-rays may demonstrate an area where the bone is also involved in the cartilage problem, but most often MRI evaluation is diagnostic of the problem. MRI is an excellent diagnostic tool that can help to clearly visualize the cartilage and determine any surface irregularity or if there is a defect or loose piece of cartilage in the joint. Early diagnosis is important to make sure that the cartilage damage is limited to a small region and where less invasive techniques may be employed to bring about resolution of symptoms.
   • Treatment Options: Non-surgical treatments include rest, ice, and physical therapy. Surgical options like arthroscopic procedures or cartilage transplants may be necessary for severe cases.
2. Meniscus Cartilage Injury:
   • Causes: Can occur from an athletic injury (twisting or contact). Alternatively, can occur from normal wear and tear of a joint without a pre-existing injury.
   • Symptoms: Pain, swelling, and a feeling of the knee locking or catching.
   • Diagnosis: As with articular cartilage injuries, the physical examination is helpful in determining the location of the pain along the joint. Twisting and hyper-flexing the knee may elicit symptoms (McMurray’s sign). X-rays are typically evaluated to look for signs of significant cartilage degeneration (arthritis). An MRI may be ordered to further evaluate the tear and often is diagnostic of the tear pattern and location of the injury (medial or lateral meniscus). As with articular cartilage injuries, early diagnosis is key to initiate treatment and prevent further joint damage.
   • Treatment: Depending on the severity, surgery such as meniscus repair or trimming may be recommended.

Treatment Options for Articular and Meniscal Cartilage at the Rothman Orthopaedics 

Rothman Orthopaedics offers advanced treatment options for knee cartilage injuries, tailored to each patient's needs and the size and scope of their cartilage or meniscus injury:

• Non-Surgical Treatments: Including rest, ice, medications, and physical therapy to manage symptoms and promote healing. Therapy often involves the use of muscle strengthening that doesn’t harm the joint (closed chain strengthening). These exercises aim to strengthen the pelvic and core muscles, hip muscles, and hamstring and quadricep muscles around the knee. By strengthening the musculature, the joint experiences less stress and the affected cartilage can be off-loaded. Therapeutic braces can be used to help stabilize the joint, and in some instances, to take pressure off of the area where the cartilage is affected (e.g. unloader brace). Recent investigations evaluating hyaluronic acid injections, platelet rich plasma injection therapy, and stem cell treatments have been performed and may be options as we learn more about these therapies and their potential role in helping patients with cartilage injuries.
• Surgical Interventions: Various surgical procedures are available, such as:
  • Arthroscopic Procedures: Used for smoothing out rough cartilage surfaces and removing loose pieces. This is called a chondroplasty or loose body removal and is typically employed for small surface lesions. In some instances, the loose piece or semi-detached piece of cartilage can be repaired back with the use of bioabsorbable screws or pins. For larger lesions that may also be deeper into the cartilage, arthroscopy can be used as a diagnostic tool and for staging the cartilage injury for a subsequent, more advanced procedure.
  • Cartilage Transplantation: For larger lesions that don’t involve a significant portion of bone, a cartilage transplant can be used after culturing the patient’s own cells (which are grown in a lab after an initial harvest procedure) and then implanting them once mature into the defect area. For larger lesions that also involve the underlying bone beneath the cartilage, an allograft (donor graft) of cartilage and bone can be harvested and implanted into the damaged area.
  • Microfracture: Stimulates new cartilage growth in small, damaged areas. This is often performed arthroscopically for small lesions that penetrate down to bone. The procedure involves placing small holes into the defect area so that marrow stem cells can populate the area and fill the area with a repair cartilage.
• Post-operative Recovery: Recovery is based on the size of the cartilage injury, type of treatment, and patient specific factors in the recovery process. Arthroscopic procedures may have a quicker timeline, except when cartilage is being repaired or expected to grow over time and incorporate into the joint. Healing may be as quick as 6 weeks to 3 months for meniscus tear procedures to 6-9 months for articular cartilage repair surgery.

Specialized Care at Rothman Orthopaedics:

For patients seeking knee cartilage treatment, Rothman Orthopaedics offers:

• Cutting-Edge Technology: Utilizing advanced techniques for accurate diagnosis and effective treatment.
• Experienced Specialists: Fellowship-trained knee surgeons specializing in orthopaedic care.
• Patient-Centered Approach: Personalized treatment plans to ensure the best possible outcomes for each patient.

Schedule Your Appointment

Don’t let knee cartilage injuries limit your active lifestyle. Contact Rothman Orthopaedics today to schedule a consultation with one of our specialists. Restore mobility and alleviate pain with the most advanced knee cartilage treatments available.