Treatment Of Knee Cartilage Damage
Non-surgical options
To manage pain and swelling in the days immediately after an injury:
- take over-the-counter anti-inflammatories
- ice your knee two to three times a day, for 20 mins at a time
- elevate your leg as much as possible
- support your knee as it recovers by wearing a knee brace
One of our physiotherapists can also give you exercises to help regain motion and build up muscle strength around the knee.
Surgical options
If your cartilage damage is severe or not responding to physiotherapy, your orthopaedic surgeon might recommend surgery.
Keyhole surgery Your surgeon repairs damaged cartilage by inserting surgical instruments through small cuts in your knee. The operation is carried out using a tiny video camera inserted into your knee and a monitor. Cartilage repair can involve shaving or cutting off ragged edges of torn tissue. If the cartilage doesn’t need replacing, your surgeon may drill small holes in the surface of the bone to encourage the cartilage to re-grow in place. In some cases, cartilage from another part of your body can be grafted onto the bones.
Open surgery in some cases, your surgeon will operate by making a larger incision to open up the entire knee joint.
Anonymous, Cromwell Hospital patient
How Is A Pcl Injury Diagnosed
Adrian will discuss your symptoms with you and examine your knee to check for tenderness, stiffness, swelling and any difficulties with movement. In most cases, he will arrange for you to have an X-ray to confirm the diagnosis. He will also arrange for you to have a magnetic resonance imaging scan to show the extent of the injury and any damage to the surrounding area.
Institute For Cartilage Repair
The HSS Institute for Cartilage Repair focuses on the treatment of symptomatic cartilage lesions. Articular cartilage, the cartilage that lines joints such as the knee, hip, ankle and shoulder, does not have the capability to repair itself. As such, injuries to cartilage surfaces often result in pain, poor joint function, and arthritis. The Institute for Cartilage Repair was developed by a skilled group of clinicians in response to growing clinical need for more durable cartilage and meniscal repair procedures. Its multidisciplinary team of surgeons, radiologists, clinicians, physical therapists, and researchers have focused on the problems of detecting and treating cartilage injury for many years and offer the latest in surgical treatment, diagnostic imaging, and clinical outcomes research. The Institute offers patients a comprehensive resource in specialty cartilage repair.
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Is A Cartilage Defect The Same As Arthritis
No! This is very important to understand, as the treatments for a cartilage defect and the treatment of arthritis are very different. The treatments for cartilage defects are not appropriate, under any circumstance, for patients who have widespread arthritis of a joint. Performing any of the following procedures in a patient with arthritis will lead to poor results.
Our Unique Approach To Articular Cartilage Repair
Early identification and treatment of articular cartilage damage can have a significant effect on outcomes for patients. We address cartilage damage as part of our biologic joint replacement procedure. By repairing or replacing the damaged cartilage before it completely wears out, the arthritic damage can be reversed and the joints preserved.
If this step is not taken, eventually the cartilage wear will progress so much that the bones will touch on each side of the joint, called bone on bone wear. At this stage, artificial joint replacement becomes necessary.
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Possible Surgeries For Articular Cartilage Injury
Anterior Cruciate Ligament Injuries
The ACL is one of the main stabilising ligaments in the knee, connecting the thighbone to the shin bone. ACL injuries are increasingly common, particularly during sports such as football, tennis, squash, rugby and skiing, and currently affect around 40,000 people in the UK each year, including increasing numbers of children.
The ACL is in the middle of the knee and controls rotation as well as the forward movement of the shin on the thigh bone. If its torn, the knee becomes unstable when it is twisted and can give way, as well as losing its full range of movement. As the knee gives way, the delicate structures inside it, as well as the joint surface and meniscal cartilages, frequently become damaged.
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How Is A Cartilage Injury Diagnosed
Symptoms of cartilage damage can include persistent pain, catching, swelling, locking, and crunching sensations.
If you suspect a cartilage injury, says Skendzel, come into our office. Well get X-rays to rule out arthritis as the cause. If cartilage injury seems likely, well do an MRI, and possibly an arthroscopy, to evaluate the size and location of the lesion. We cant regrow cartilage thats gone from the entire back of a kneecap or the whole inside of a knee. However, if there is only a small area of cartilage missing, we do have treatments to regrow cartilage and repair the damage.
What Options Exist For Repairing Or Replacing Damaged Cartilage
When we evaluate patients for surgical treatment, the first thing we do is determine into which of two categories the injury falls. The first is surface damage only the cartilage is damaged but the bone beneath it is healthy. The second involves damage to both the cartilage and underlying bone.
When only the cartilage needs repair, its something like fixing a pothole, and there are a number of techniques to consider.
According to the FDA, the current gold standard of care is a procedure called microfracture. During microfracture, a surgeon cleans up the area of injury, removing the damaged cartilage and exposing healthy edges of the surrounding cartilage. The surgeon then drills small holes in the bone at the base of the defect. Over time, bone marrow cells will rise up through the holes and form a clot. After surgery, the patient must participate in a course of specific exercises and therapy. This specific rehabilitation program helps to ensure that the clotted cells will turn into cartilage, rather than becoming stiff like bone or scar tissue.
Patients with small areas of damage who commit to the necessary rehabilitation have good success with microfracture, although the benefits tend to decrease over time, with symptoms returning after a few years.
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A similar approach, called , is currently being evaluated in a clinical trial. Michigan Medicine is the only site in the state participating in the trial.
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Knee Cartilage Injuries Can Lead To Chronic Pain
In the United States, chronic knee pain is a prevalent issue affecting many peoples health. Knee pain is the second most common cause of chronic pain among Americans. It sends more than 12 million to the doctors office each year. Half of these people have damage to their knee cartilage.
Knee cartilage injuries arent just reserved for athletes. They can happen to anyone. And, they can occur in a number of different ways, including:
- repetitive movements during light exercise and other physical activity
- acute or traumatic events like a serious fall.
Unlike other tissue injuries, cartilage injuries do not repair themselves. This is because of a lack of blood supply to the damaged area.
Therefore, cartilage damage can often be chronic. And it can get worse over time if not treated properly. This may cause limited mobility that forces people to give up the activities they love the most.
Grading Articular Cartilage Injury
The degree of cartilage damage is also possible to rank, the International Cartilage Repair Society has established an arthroscopic degree/ or grading system which ranks the severity of articular cartilage injury:
- Degree 0: A normal or a healthy knee articular cartilage.
- Degree 1: Blisters or soft spots started appearing on the knee articular cartilage.
- Degree 2: The knee articular cartilage has small tears seen on the cartilage.
- Degree 3: More than 50 percentage of the articular cartilage has lesions that have deep crevices.
- Degree 4: The underlying sub chronal knee bone is visible and the knee articular cartilage has damaged severely.
The size / width of each individual injury will also be calculated. An injury to the articular cartilage which is less than 2 square centimeters is marked as tiny. Where the injury is located can also influence severity of pain, function and the medical care. The pain experienced by an individual is not a good indicator to the severity of the articular cartilage injury. Some individuals may have very moderate pain and have more severe injury than others with serious pain.
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Dr Skendzel Explains Treatments For Knee Cartilage Injuries
Our cartilage stabilizes our knees and keeps the knee joint moving smoothly. When an injury damages cartilage and affects knee function, Dr. Skendzel explains the procedures available to treat these injuries and preserve function.
Not all cartilage defects are created equal, says Summit Orthopedics sports medicine surgeon Dr. Jack Skendzel, who specializes in treating athletes and other patients with knee injuries. We offer a number of knee cartilage injury treatment options, depending on the size and location of the defect and the age of the patient.
About Knee Cartilage Damage
The bones of your knee joint are coated with a layer of slippery tissue called cartilage, which reduces friction as the bones move over each other. Cartilage can be damaged or torn as a result of an accident or conditions such as arthritis.
Knee cartilage damage can be caused by a sudden twisting movement or a direct impact to the knee both of which happen in sports such as rugby, squash, football or skiing.
Arthritis is a common cause of knee cartilage damage. There are two main types of arthritis:
- osteoarthritis a degenerative condition that wears away bone and cartilage.
- rheumatoid arthritis an inflammatory disease causing swelling and stiffness in your joints, which can damage the bones and cartilage.
Minor cartilage damage can get better on its own after a few days, although more serious injuries or conditions will need treatment.
Cartilage has very little blood supply, meaning it is hard for it to repair itself. Surgery is usually the only option for more serious damage.
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How Is A Pcl Injury Treated
In most cases, if the PCL is the only ligament affected, it can be treated without surgery by resting the knee, elevating it and following a programme of physiotherapy you may also be advised to wear a knee brace. In more serious cases, Adrian may advise that you have ligament surgery.
Adrian has developed a new technique for PCL surgery which involves reinforcing the reconstruction with fibre tape . Adrian has the largest experience globally with this technique, which has revolutionised the results of PCL surgery, and is frequently asked to demonstrate it to other surgeons.
Final Word From Sportdoctorlondon About The Treatment Of No Cartilage In Knee
Loss of cartilage in the knee is common as we get older. Weight loss and exercise are the best medicines to reduce pain and improve activity. Only use injections sparingly to help with lifestyle factors with a preference for gel and PRP. Avoid any expensive treatments like stem cells that promise regeneration. Finally, consider a knee replacement if all other treatments fail and your ability to exercise drops.
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Summit Orthopedics Offers Comprehensive Sports Medicine Expertise
From Olympians to pro athletes to kids in youth sports and those that just want to be more activeSummit Orthopedics delivers expert care by fellowship-trained sports medicine physicians. If you are recently injured or concerned about ongoing pain, Summit Orthopedics sports medicine specialists have the expertise to evaluate your discomfort and develop a plan to quickly and safely help you get back to being active.
Start your journey to stronger, healthier athletic condition. Find your sports medicine expert, request an appointment online, or call us at to schedule a sports medicine consultation.
Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Vadnais Heights, MN, Plymouth, MN, and Woodbury, MN, as well as several additional community clinics.
A Survey Of Knee Pain Sufferers
The Harris Poll recently conducted a survey of knee pain sufferers on behalf of Vericel, the manufacturer of a knee cartilage procedure called MACI. It found that over half of knee pain sufferers experienced a decrease in their mobility since they first experienced knee pain.
As time went on, those who did not seek treatment, found themselves with even less mobility. This impacted their ability to participate in the activities they once enjoyed.
Nearly three-quarters of the knee pain sufferers who used to play team sports said they no longer played. A similar proportion of prior runners said the same. Additionally, nearly 8 in 10 said they forgot what it was like to be pain-free.
Despite living in pain and missing out on the things they love, a majority of people admit theyd rather deal with their knee pain and manage it with medication than undergo surgery.
Moreover, many admit they arent even actively looking for a solution to their knee pain. According to the survey, nearly 3 in 4 knee pain sufferers hope their knee pain will just resolve itself. Others cited different reasons for not pursuing treatment, including:
- fear the surgery will not work
- fear they will not be able to return to their pre-knee pain activity level
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Treatment Summary For Articular Cartilage Injury
- Rest, Ice, Compression, and Elevation is a technique which can be useful in minimizing swelling.
- Nonsteroidal anti inflammatories are used to reduce pain and swelling.
- The affected individual is advised to see a sports Injury specialist.
- An X-ray or arthroscopic surgery is done for confirmatory diagnosis.
- As mentioned above, rest is imperative.
- The affected patient should be enrolled in a rehabilitation program.
- If a fracture is identified for example in osteochondritis dissecans, surgery becomes necessary to required repair the broken fragment.
- There is another surgical procedure which involves recruitment of marrow stem cells into the affected area by piercing the subchondral bone so as to accelerate recovery of the articular cartilage.
Where Can I Find A Knee Cartilage Repair Specialist In New York
When youre faced with a painful knee cartilage injury, seeing a specialist is vital. NY Orthopedics fellowship trained sports medicine physician, Dr. George Ackerman, is an expert in providing the latest cartilage repair treatments for the kneetreatments designed to get you back to your active life, without knee pain. If youve experienced a knee cartilage injury, request a consultation with Dr. Ackerman today to learn more about your treatment options.
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Knee Cartilage Repair Regeneration And Replacement
There are two primary types of cartilage in the knee: articular cartilage and meniscus . SeeSoft Tissue of the Knee Joint
These surgeries can be performed on almost any joint, but they are most commonly performed on knees. They are generally appropriate for people who have specific cartilage injuries rather than widespread cartilage damage, like that found in moderate to severe knee arthritis.
Total Pain Free And Function Improvement Of A Torn Meniscus In Left Knee
PA, United States, 2004
A male patient, age 46, was diagnosed with a torn meniscus in his left knee in 2004 . Various attempts of treatment had failed to deliver complete relief. Functional improvement amounted to about 50% only after a four week treatment.
The patient started to use herbal treatment solutions. Within minutes after beginning the first herbal treatment the pain level reduced by at least 50%. After two weeks of herbal treatment, the patient had regained 90% functionality . A maintenance care had been applied ever since. The results had sustained ever since . ** DISCLAIMER:Individual results may vary.
- Aurora, ON L4G 1L8, Canada
- Joseph L. Dumovic, DC, NDNA
- Bonita Springs, FL 34135 United States
- James Foy, DC
- Los Angeles, CA, 90048 Brooklyn, NY, 11238
- Jack Kucheran, DC
- Joseph Rockman, LAc, LMT, MSOMLong Beach, NY 11561
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Top Orthopaedists Weigh In On Cartilage Injuries
Cartilage in the knee is the protective covering that lets our joints glide comfortably. When a quick twist or sudden impact causes a tear, we realize the crucial job it does for our joints. When this type of trauma happens, it can be confusing to decide on treatment. At Rothman Orthopaedic Institute, we believe that education is an integral part of your recovery plan, and as such, our expert orthopaedists would like to offer their insights into some of the best cartilage injury treatments available today.