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    Knee - Cartilage Injuries

    Overview
    Meniscus Injuries
    Articular Cartilage Injury
    Treatment
    Where to Seek Treatment
    Return to Knee Injuries
    Singapore General Hospital
    Contributed by Dept of Orthopaedic Surgery

    Overview

    Cartilage Injuries

    The cartilage is a connective tissue that acts as a shock absorbing structure and provides a smooth surface for the knee joints. They are 2 types of cartilage in the knee - meniscus and articular.


    1. Meniscus Injuries

    The meniscus acts as a shock absorber during weight-bearing activities and helps to maintain knee joint stability. It is a commonly injured part of the knee.

    Causes

    A meniscus tear can be caused by contact or non-contact activity when a weight- bearing knee moves or twists suddenly. It can also occur as a result of wear and tear.

    Symptoms

    • Knee pain
    • Swelling of the knee
    • Locking of the knee
    • Inability to straighten or bend the knee fully
    • Difficulty walking due to pain

    Diagnosis

    Diagnosis is made after your doctor takes your case history and clinical examination.

    A MRI may also be useful for diagnosing tear/s of the meniscus. 

    Treatment for Meniscus

    Non-surgical treatment includes rest, elevation and ice therapy of the affected limb.

    Crutches can help take the weight off the affected limb, and physiotherapy, after the pain subsides, can help improve the range of motion and strengthen the muscles around the knee.

    If the meniscus does not heal by itself, surgical repair or excision of the meniscus may be needed if you continue to experience persistent pain, locking of the knee or are unable to achieve full range of motion.


    2. Articular Cartilage Injury

    The articular cartilage is the smooth covering at the end of the bones that allows for frictionless gliding of one bone against another. It also acts as a shock absorber.

    Causes 

    The surface can be damaged by direct trauma or through chronic wear and tear.

    Symptoms

    • Recurrent pain
    • Swelling of the knee
    • May experience difficulty straightening or bending the knee
    • There may be audible ‘clicks’ on knee movement

    Diagnosis

    An x-ray and MRI may be useful in the diagnosis.

    Treatment for Cartilage

    Rest, ice and compress should be the first course of treatment upon injury.

    Crutches can also be used to ease pressure on the sore knee, followed by physiotherapy, when the pain subsides, to strengthen the muscles and for range of motion.

    Medications such as non-steroidal anti-inflammatory drugs are useful for pain relief and reducing inflammation.


    Treatment

    Surgical Options

    As the ability of the cartilage to heal by itself is limited, your surgeon may recommend that you undergo resurfacing procedures. Some of the surgical options include:

    • Arthroscopic microfracture techniques to help fill the defect with blood clot and stem cells
    • Osteochondral autograft transfer techniques where plugs of cartilage, together with its supporting bone foundation, are taken from a less critical part of the knee and transplanted to cover the defect
    • Autologous cartilage implantation techniques where cartilage cells are harvested from the knee, grown and multiplied in the laboratory, and subsequently implanted back into the joint to cover the defect
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