Orthopaedic Surgeon | Foot, Ankle, & Knee Specialist

  Monday to Friday 9am to 5pm
      (08) 7099 0188

Knee cartilage damage

What is cartilage?

There are many forms of cartilage in the body. The cartilage that lines the knee joint, and many other joints in the body, is called ‘Articular cartilage’. This articular cartilage provides a protective covering over the ends of the bones that make up the knee joint. It allows for a very low level of friction during normal function, and protects our joints from pain during walking.

dr mike smith orthopaedic knee surgeon adelaide knee cartilage damageWhat causes knee cartilage damage?

Articular cartilage can be damaged in several ways. A local area of cartilage damage can occur during a direct injury to the knee. This can result in a small-moderate sized area of cartilage ‘coming away’ from the end of the bone that it is protecting. Generalised ‘wear and tear’ of the articular cartilage is termed ‘Arthritis’ and is very common with increasing age. Dislocations of the knee cap (patella) can also result in damage to the cartilage, as the knee cap ‘knocks’ off a piece of articular cartilage during its displacement.

Knee cartilage damage – Symptoms

Localised cartilage loss often results in pain over the ‘lesion’, catching and clicking, stiffness, and swelling of the knee. The catching and clicking is often the result of either a loose body inside the knee joint, or an unstable ‘flap’ of articular cartilage.

Knee cartilage damage – Making the diagnosis

Local cartilage damage is best appreciated on an MRI scan or an arthroscopy. Xrays are often normal, as the adjacent cartilage is intact, the bone ends usually maintain there relationship.

dr mike smith orthopaedic knee surgeon adelaide knee cartilage damageAn MRI scan shows excellent detail of the overall state of cartilage, in comparison to xrays and a CT scan. However, it is not 100% accurate, and arthroscopy is considered the gold standard for this assessment.

cartilage loss knee arthritis treatment mike smith adelaide knee specialist

An arthroscopy gives the most detailed evaluation of the lesion. This determines the size of the lesion, the exact location in respect to weight bearing forces, and any additional damage to the meniscus or cruciate ligaments.

Why doesn’t articular cartilage heal?

Articular cartilage lacks a blood supply. Unfortunately, this means that once the articular cartilage is damaged, the body is unable to regenerate this same cartilage. It is possible for the body to form ‘scar (fibro-) cartilage’, to replace this damaged articular cartilage. Surgical techniques have been developed to improve the formation of this fibrocartilage.

What are the indications for cartilage surgery?

Cartilage lesions come in all shapes and sizes. It is important to undergo a thorough evaluation including a detailed history and examination, followed by an MRI scan.

Typically, younger patients with a single cartilage lesion are the best surgical candidates, however there are exceptions.

Knee cartilage damage – Surgical Options

The majority of the treatment options are performed arthroscopically, depending on the complexity of the case.

Chondroplasty

Arthroscopic debridement of loose/unstable cartilage flaps back to smooth surface.

Micro-fracture

After creating a stable base, small holes are created in the bone to stimulate blood flow and fibrocartilage formation.

Matrix Induced Autologous Chondrocyte Implantation (MACI)

MACI is a 2 step procedure aimed at restoring normal articular cartilage to the knee joint.

Osteochondral Autograft Transplantation (OAT)

An OATs procedure uses a less important donor site to harvest a bone/cartilage plug, and to insert it into the more important region that is affected.

 

Dr. Mike Smith and his staff can be contacted by one of the methods outlined below. If requested, all new patients will be reviewed within one week of booking an appointment. We look forward to assisting you!

  • Patient Contact Form

​Urgent Referrals & Emergencies

Email Referral

Feel free to email your referral to our friendly staff who will promptly book an appointment.

Email
Online Referral

Refer a patient using our secure online patient referral portal here.

Online Referral
Phone Referral

Contact our friendly staff directly on
08 7099 0188

Phone
Fax Referral

Please fax your referral to 08 7099 0171. Dr. Smith's rooms will contact your patient within 24 hours, with an appointment time.

Fax