The bones of your knee are covered with a padding of articular cartilage which is different from the cartilage of the shock absorbing disc between the bones called the meniscus. The cartilage on the ends of the bones is very thick when we are born and over time it wears away. However, there can be injuries that unfortunately will wear or chip the cartilage creating a tear or defect of the cartilage. Most patients with these cartilage “tears” will have symptoms of locking and catching, as well as, swelling in the knee. You may or may not remember exactly what has caused the problems.
How to identify cartilage problems of the knee?
Often times after a history and physical examination, suspicion for a cartilage defect may be confirmed with an MRI to determine the extent of the cartilage injury. Once the injury has been identified anti-inflammatory medicine and physical therapy for strengthening the knee can reduce the symptoms. However, some persistent symptoms may require surgery. An arthroscopic procedure can provide good results for patients that have not had good relief of their pain and symptoms from their cartilage injuries.
What are the treatment options for cartilage problems of the knee?
One procedure is an arthroscopic technique which drills holes into the cartilage defect. The purpose of this technique is to penetrate into the bone marrow so stem cells can come through these holes and fill in the defect to grow a layer of fibrocartilage which is like your normal cartilage. This technique is known as microfracture or marrow simulating technique. There are other techniques for larger cartilage defects or for patients who have had microfracture and continued pain. These procedures are generally known as cartilage transplant procedures or mosaicplasty. This is best for addressing larger defects of the cartilage and involves taking cartilage from another area of your knee that does not have as much weight bearing and transplanting it to the area that has the defect. Another option is removing some of your cartilage and sending it to a laboratory to amplifying the cartilage then returning for more surgery to re-implant the cultured cartilage back into the knee. If you have questions about cartilage tears or defects in your knee, please feel free to contact me or schedule an appointment.