Knee Cartilage

Articular cartilage of joints such as the knee is essential to the joint’s normal function.  It acts as a cushion or load bearing structure and provides a friction free surface. 

  

                  Healthy Knee Cartilage

                 Healthy Knee Cartilage

 OCD lesion causing cartilage defect

OCD lesion causing cartilage defect

Knee Cartilage Injuries

Unfortunately , articular cartilage is susceptible to traumatic injury or pathologic conditions such as osteochondritis dissecans, which can, over time, be particularly disabling in the athlete. When this occurs patients may experience pain or swelling in the knee. 

 Arthroscopic view of cartilage loss

Arthroscopic view of cartilage loss

 MRI showing osteochondritis dessicans lesion

MRI showing osteochondritis dessicans lesion

Treatment

Nonoperative

In young patients with open growth plates, cartilage lesions may heal with relative rest and inactivity. 

Surgical

In skeletally mature patients surgical intervention is usually required. Current articular cartilage resurfacing procedures can be divided into three categories:

Bone Marrow Stimulation

Using this technique, tiny perforations are made in the bone underlying the cartilage in an effort to stimulate healing of the cartilage defect. 


Implantation of Autologous Articular Cartilage

   
  
 
  
    
  
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Cartilage from another part of the knee that does not bear weight may be harvested and transplanted to the injured area.


Transplantation of Osteochondral Allograft

In some cases the cartilage defect is very large and a donor cartilage graft is used to fill the defect.

 


There are other cases where the cartilage defect may be addressed by fixation with bone graft and a screw or through drilling to promote healing. 

The best treatment approach takes into account the size of the lesion, condition of the cartilage in question and age of the patient.  Dr. Marshall will discuss his thought process and your treatment plan in detail at your appointment.

Recovery

Patients are encouraged to begin physical therapy postoperative day one. For most cartilage procedures you can expect to be touch down weight bearing with crutches for 6wks.  After that time period activities are increased. Return to sports and running usually occurs around 3-4 months after surgery.