Cartilage Damage, Tears or Injuries

Damage to the Smooth Cushioning Surface of the Knee Joint

Cartilage is an essential tissue found throughout your body, acting as a cushion between the bones in your joints. In the knee, cartilage allows for smooth movement with minimal friction, enabling you to perform daily activities without pain. The knee has two types of cartilage: articular cartilage, which covers the ends of your bones, and the meniscus, which acts as a shock absorber between the femur (thigh bone) and tibia (shin bone). When the cartilage in your knee becomes damaged or torn, it can lead to pain, swelling, and restricted movement, severely impacting your quality of life.

COMMON CAUSES OF CARTILAGE DAMAGE

Cartilage damage can occur due to various factors, ranging from trauma to gradual wear and tear. Some common causes include:

Wear and tear: Over time, the cartilage in your knee can wear down, especially if you have been highly active or are older. This gradual degeneration can lead to cartilage breakdown.
Joint dislocation: A sudden injury that forces the knee joint out of place can cause significant cartilage damage.
Meniscal tears: A sharp twist or heavy load on your knee can lead to tears in the meniscus, affecting both the shock-absorbing ability and the health of the joint.
Trauma or accidents: A fall, direct blow to the knee, or car accident can damage or tear the cartilage in your knee joint.
Inflammation or arthritis: Conditions like arthritis, particularly osteoarthritis and rheumatoid arthritis, can inflame the knee and damage the cartilage over time.

TYPES OF CARTILAGE INJURIES

The type of cartilage injury in your knee will depend on which cartilage is affected. The two main types of cartilage in the knee are:

Articular cartilage injury: This smooth tissue covers the ends of your bones, allowing them to glide smoothly across each other when you move. Damage to this cartilage can lead to increased friction, causing pain, stiffness, and reduced mobility.
Meniscal injury: The menisci are two C-shaped pieces of cartilage that sit between the bones of the knee. These structures absorb shock and help stabilise the joint. A torn meniscus can cause pain, swelling, and instability in your knee.

SYMPTOMS OF CARTILAGE DAMAGE IN THE KNEE

Cartilage injuries, whether in the articular cartilage or the meniscus, often present similar symptoms. You may experience:

Sharp pain at the time of injury or a dull ache in cases of degenerative damage.
Swelling, especially after physical activity or prolonged periods of standing.
Catching or locking of the knee, which may be caused by loose fragments of cartilage interfering with normal joint movement.
Decreased range of motion in your knee, making it difficult to fully straighten or bend the joint.
Instability or the feeling that your knee may give way during movement, particularly after a meniscal tear.

HOW IS CARTILAGE DAMAGE DIAGNOSED?

Diagnosing cartilage damage involves a careful assessment of your symptoms, medical history, and the use of imaging or keyhole techniques to get a clear view of the joint surfaces. Dr Liddell uses a thorough, step-by-step approach to ensure the cause of your knee pain is accurately identified and appropriately managed.

The diagnostic process may include:

Medical History Review: Dr Liddell will ask about previous injuries, surgeries, or conditions such as arthritis that could affect the cartilage in your knee.
Physical Examination: He will check your knee for swelling, tenderness, clicking, or restricted movement. Tests will be performed to assess joint stability and range of motion.
X-Rays: While cartilage itself doesn’t appear on X-ray, these images help rule out fractures or show joint space narrowing, which may indicate cartilage loss or wear.
MRI Scan: An MRI provides detailed images of the knee’s soft tissues, including cartilage. It can reveal tears, thinning, or surface irregularities and help guide treatment planning.
Diagnostic Arthroscopy: (in select cases) If more detail is needed, Dr Liddell may recommend arthroscopy, a minimally invasive procedure using a small camera to view the joint directly. It allows for highly accurate assessment and, in some cases, minor repairs at the same time.

This comprehensive approach helps ensure any cartilage damage is clearly understood so that a personalised treatment plan can be created to relieve symptoms and support better knee function.

TREATMENT OPTIONS FOR CARTILAGE DAMAGE

The treatment of cartilage injuries depends on the severity of the damage, the type of cartilage affected, and your personal activity level and goals. Both non-surgical and surgical options are available, and Dr Liddell will discuss which approach is most appropriate for your specific case.

Non-Surgical Treatments

Many patients respond well to non-surgical treatments, particularly if the cartilage damage is mild or moderate.

Some common options include:

RICE Therapy: Rest, Ice, Compression, and Elevation are typically recommended to manage pain and reduce swelling.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen can help reduce pain and inflammation.
Bracing: A knee brace may be used to provide support and stabilisation, allowing the cartilage to heal naturally.
Physiotherapy: A tailored physiotherapy program can help strengthen the muscles around your knee, improve flexibility, and restore joint function.
Non-Weight-Bearing Activities: Temporarily avoiding putting pressure on the affected knee can allow damaged cartilage to heal.

Surgical Treatments

In more severe cases, or when non-surgical options do not provide relief, surgery may be necessary to restore knee function. Some common surgical treatments include:

Debridement: In this procedure, damaged cartilage is shaved or smoothed using arthroscopy, creating a smoother surface for the knee joint to move.
Microfracture: This technique involves creating small holes in the bone to stimulate the formation of new cartilage. It’s particularly useful for small areas of damaged cartilage.
Cartilage Transplantation: For larger or more complex injuries, cartilage transplantation may be recommended. This involves using healthy cartilage from elsewhere in your body or a donor to replace the damaged tissue.

Recovering from cartilage damage depends on the severity of the injury and the type of treatment you receive. If you opt for non-surgical treatment, rehabilitation may take several weeks, with gradual improvements in strength and mobility. If you undergo surgery, your recovery period will be longer and will involve a structured rehabilitation program with physiotherapy to help restore knee function.

Dr Liddell will work closely with you to create a personalised recovery plan, focusing on regaining knee strength, mobility, and stability. Whether your treatment involves surgery or not, a carefully managed rehabilitation plan is key to achieving the best long-term outcome.