Diagnosis |
ARTICULAR CARTILAGE INJURY
(Osteochondritis Dissecans is one form of
this injury)
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| Definition |
Damage to the smooth surface on the end
of bones inside a knee joint. (Femur/Tibia/Patella)
Model
and X-ray of a Normal Knee |
| Details |
Articular cartilage is the material that
covers bone inside a joint. It normally is very smooth. Its function
is to help the bones glide easily past each other during motion of
the knee. It also protects the underlying bone. Injuries or disease
can result in defects or uneven areas in this important surface.
Arthroscopic
Picture of Normal Cartilage |
| Causes |
Articular cartilage injuries may be
caused by a sudden knee injury (acute trauma), osteoarthritis,
or less commonly, by a developmental disorder known as
osteochondritis dissecans. |
| Diagnosis |
An articular cartilage injury is
diagnosed by a history of an acute knee injury or by chronic dull
ache inside their knee. Physical examination may reveal isolated
areas of tenderness around the outside of the knee. X-rays may
reveal defects in the bone surface or advanced arthritis. An
MRI should clearly demonstrates the extent of damage to the
cartilage.
MRI
of Osteochondritis Dissecans Lesion |
| Treatment |
Nonoperative Treatment
- Phase I: Control of pain and inflammation REST, Icing,
Stretching, Anti-inflammatory medication
- Phase II: Restore strength and function
- Phase III: Return to work or sports specific activities
If nonoperative treament fails then arthroscopic
(minimally invasive) surgery may be required to
smooth the cartilage or attempt to repair it. If the damage is
severe, however, more advanced techniques like osteochondral
transfer, osteotomy or even total knee replacement may be
considered.
Cartilage
transfer surgery pictures |
| Prevention |
Avoid overuse and isolated knee extension exercises
Always warm up before playing or training
Consider a complete lower extremity stretching and strengthening
program
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