A chondral defect is an injury to the articular cartilage that occurs when one twists or pivots while the knee is bent. The articular cartilage is found at the end of each of the bones that make up the knee. Once the cartilage is torn it will not heal easily and can lead to degeneration of the articular surface, leading to development of osteoarthritis.
Causes
- degenerative condition (osteoarthritis) occurring in older people.
- a direct blow to the knee or a single traumatic event
- trauma such as accidents, mechanical injury such as a fall
- result of a series of minor injuries over an extended period.
- may be accompanied by another injury such as one to the ACL
Diagnosis
Patients with articular cartilage damage experience symptoms such as joint pain, swelling, stiffness, and a decrease in range of motion of the knee. Swelling is typically the main symptom experienced. A detailed medical history with x-ray and/or MRI. Is necessary for diagnostic purposes. Small pieces of cartilage can break off and then float around in the knee. These fragments are the cause of the swelling and can cause pain when walking or climbing stairs for extended periods of time. The fragments can interfere with the mechanics of the knee, getting caught in the joint as it bends and causing the knee to lock.
Treatment
Cartilage is not able to repair itself, so other forms of treatment are needed for these injuries. Treatment for Chondral defects ranges widely depending on the extent of the injury. Implantation of Regenerative Cell Therapy/ Orthobiologics has also been used successfully to treat injuries to cartilage. The least invasive treatment is done when the injury is at the end of the femur Surgical procedures are not as effective if the injury is on the tibia or patella. Damaged cartilage may be replaced with healthy cartilage and the procedure is known as cartilage replacement. It is a surgical procedure performed to replace the worn-out cartilage and is usually performed to treat patients with small areas of cartilage damage usually caused by sports or traumatic injuries. It is not indicated for those patients who have advanced arthritis of knee. Cartilage replacement helps relieve pain, restore normal function, and can delay or prevent the onset of arthritis. The goal of cartilage replacement procedures is to stimulate growth of new hyaline cartilage. Various arthroscopic procedures involved in cartilage replacement include:
- Microfracture –arthroscopic surgical technique developed to treat defects when the injury extends all the way to the bone
- Drilling
- Abrasion Arthroplasty
- Autologous chondrocyte implantation (ACI)
- Osteochondral Autograft Transplantation