KNEE CARTILAGE INJURIES
The Knee joint is compose of the shinbone(Tibia), thighbone(femur) and the kneecap(Patella). These bones that meet at the joint are covered with a thin layer of cartilage known as Articular cartilage. It forms a smooth,durable covering at the ends of each bone in the joint. This smooth cartilage allows the bones to move easily within the joint and slide over each other without friction.
How do articular cartilage injuries occur:
- Forceful impacts to the joint due to sports injuries or fall
- repetitive smaller impacts to the joint
- twisting the joint while it bears weight
- progressive wear and tear overtime
What are the symptoms:
- pain and swelling of the joint
- a ” catching” feeling when bending
- “grating sound” when bending
- joint “locking” 9inability to fully extend or bend the knee)
- feeling of giving way
- limited range of motion
How are articular cartilage injuries diagnosed:
- History and Physical examination: observe how the knee joints move,range of motion, swelling
- Xray (loose bodies,fractures,and osteoarthritis as source of pain)
- MRI scan helps to quantify the extent of cartilage damage, evaluate size and depth of cartilage injury
- Knee Arthroscopy- diagnostic tool. A small camera is inserted into the joint and determine the extent and type of damage
Treatments:
A. Non-surgical Treatment
- Rest and strengthening exercises, Ice ,NSAIDS,Brace to unload the joint)
- Viscosupplementation
- Injecting Hyaluronic Acid to the joint. This lubricates the joint reducing friction between bones in the joint decreasing pain
- Injection of PRP (Platelet Rich Plasma) -made of blood cells called platelets which release substances called growthfactors that stimulate healing
B. Surgical Treatment
- Arthroscopic Debridement(Abrasion chondroplasty)
- smoothing the damaged cartilage and removing loose bodies
- Microfracture
- creating small holes in the base of a cartilage lesion to encourage the bone to bleed, heal and create a new cartilage surface
- Autograft Mosaicplasty (Autograft Osteochondral Transplantation)
- moving healthy cartilage-bone plugs from a low demand portion of the patients knee to be fixed to a damaged area of cartilage in the same knee.
C. AMIC (Autologous Matrix-Induced Chondrogenesis)
- a damaged cartilage is removed. Cells from the underlying bone are released into the defect, while they promote new tissue growth. the area is covered with a small piece of collagen membrane which serves as a scaffold for the new forming tissue