Your knees wouldn’t work without cartilage. This smooth tissue acts as a protective cushion, allowing your bones to glide against each other without pain. Healthy cartilage allows for smooth and nearly frictionless joint motion.
Unfortunately, cartilage can be damaged due to injury, overuse, or even just the wear and tear of aging. When this happens, you might experience pain, swelling, and a limited range of motion.
This article explores the causes and symptoms of cartilage damage in the knee and will dive into the various treatment options available, including cartilage knee surgery.
What is Knee Articular Cartilage and How Is it Damaged?
Your knee’s articular cartilage is a smooth tissue that covers the ends of the bones inside the joint. Think of it as a natural shock absorber that also allows your knee to bend and straighten with ease.
Unfortunately, this cartilage can be damaged in a number of ways. A sudden injury, like a sports injury, can tear the cartilage. Repetitive motions, such as running, can wear it down over time. And degenerative conditions like osteoarthritis can cause the cartilage to thin and break down.
Cartilage damage can range from minor surface irregularities to full-thickness tears that expose the bone underneath.
What causes knee articular cartilage damage?
Articular cartilage can be damaged in a variety of ways, including:
Injury
Acute injuries are a common cause of cartilage damage. A direct blow to the knee, a twisting injury, or a dislocation can all damage the cartilage.
Other contributing factors
Other factors can also contribute to cartilage damage, including:
- Meniscus damage. A torn meniscus can speed cartilage degeneration.
- Genetic predisposition. Some people may be genetically predisposed to cartilage damage.
- Wear and tear. Over time, the cartilage in the knee can break down due to wear and tear.
- Arthritis. Osteoarthritis is a common cause of cartilage damage.
Signs and Symptoms of Knee Cartilage Damage
What does knee cartilage damage feel like? A few common symptoms include:
- Pain, even when you’re resting
- Swelling
- Stiffness
You might also hear clicking or grinding when you move the joint. Sometimes, your knee might lock, catch, or give out completely.
If you don’t get treatment, these symptoms usually get worse over time. They might start as a minor annoyance but eventually become debilitating.
How doctors diagnose knee cartilage damage
If you’re having knee pain, your doctor will likely start with a physical exam to check your range of motion, stability, and the spots that hurt when touched. But cartilage injuries aren’t always obvious, so they’ll likely use imaging tests, too.
- X-rays can rule out other conditions and check the alignment of your bones.
- MRIs are useful for showing the soft tissues in your knee, including cartilage.
- Arthroscopy involves inserting a tiny camera inside your knee joint to look at the cartilage directly.
Treatment Options for Knee Cartilage Damage
If you’ve damaged the cartilage in your knee, there are several treatment options available, ranging from simple self-care to surgery.
Nonsurgical Treatment
For minor cartilage injuries, conservative management strategies might be all you need. These strategies often involve self-care, with the goal of reducing pain and inflammation and preventing further injury.
You might have heard of the acronym RICE, which stands for rest, ice, compression, and elevation. It’s a good way to remember the basic steps. You’ll want to protect your knee from further injury, perhaps by using a brace or other type of support. You’ll also want to rest it, elevate it, and apply ice packs regularly.
Over-the-counter pain relievers like acetaminophen (paracetamol) or NSAIDs (nonsteroidal anti-inflammatory drugs) can help with the pain. A physical therapist can show you exercises to strengthen the muscles around your knee and improve your range of motion.
Surgical Treatment
More serious cartilage damage sometimes requires surgery to repair or replace the damaged cartilage. Some of the more common surgical procedures include:
- Lavage and debridement (flushing out the joint and removing damaged cartilage)
- Marrow stimulation (encouraging new cartilage growth)
- Mosaicplasty (transferring plugs of healthy cartilage to the damaged area)
- Osteotomy (realigning the bones in the knee)
- Knee replacement (replacing the entire knee joint with an artificial joint)
Surgical repair and replacement techniques
If nonsurgical options don’t bring you sufficient relief, you and your doctor may decide to try a surgical approach. There are several different surgical techniques used to repair or replace damaged cartilage in the knee.
Overview of surgical procedures
Some common surgical procedures include:
- Lavage and debridement, in which the surgeon cleans and smooths the damaged cartilage.
- Marrow stimulation (microfracture), in which the surgeon creates tiny fractures in the bone to stimulate the growth of new cartilage.
- Mosaicplasty, in which the surgeon transplants small plugs of healthy cartilage to the damaged area.
- Osteotomy, in which the surgeon realigns the knee joint to take pressure off the damaged cartilage.
- Knee replacement, in which the surgeon replaces the entire knee joint with artificial parts.
Advanced techniques
More advanced techniques are also available, including:
- Allograft osteochondral transplantation (AOT), which involves transplanting cartilage and bone from a donor.
- Autologous chondrocyte implantation (ACI), which involves growing a patient’s own cartilage cells in a lab and then implanting them in the damaged area.
- Artificial scaffolds, which are frameworks placed in the knee to encourage cartilage growth.
Key Takeaways
If you think you may have damaged the cartilage in your knee, early diagnosis and treatment are essential. The sooner you seek care, the more options you’ll have.
There are many different ways to treat cartilage damage, from conservative treatments you can do at home to advanced surgical procedures. The best approach will depend on the severity of your injury, your age, your activity level, and your overall health.
If you have severe knee pain or if your symptoms aren’t improving with home care, talk with a qualified healthcare professional. Together, you can decide on the best path forward.