The treatment of chondral defects of the knee can depend upon the location and size of the defect. In general, those that are on the end of the thigh bone, the femur, are the ones that are easiest to treat and have the best outcomes. Those on the tibia and kneecap (patella) are harder to treat and the results are not as reliable.
Full Answer
Is conservative treatment effective for chondral defects of the knee?
Nov 30, 2011 · Conservative Treatment Conservative treatment for chondral defects of the knee can be effective for pain relief, but it cannot be used for articular cartilage restoration. Craig et al. 4) suggested that conservative treatment can be an option when mild pain is present or the risk of surgery is greater than its benefit.
What are the treatment options for chondral defects?
What is a chondral defect?
What are the benefits of CPM for chondral defect healing?
What is a chondral injury?
An articular cartilage injury, or chondral injury, may occur as a result of a pivot or twist on a bent knee, a direct blow to the knee, or wear and tear as a patient gets older. In some cases, chondral injuries may accompany an injury to a ligament such as the anterior cruciate ligament (ACL). Small pieces of the articular cartilage can break ...
How to prevent cartilage damage in knee?
What are the most important things a person can do to limit chondral or cartilage damage in the knee? 1 Since excess weight can cause damaged cartilage to wear down more quickly, losing extra pounds may be helpful. 2 A person with cartilage damage should avoid high impact activities, such as prolonged running or jumping sports. These are very hard on the knee and can speed the progression of cartilage damage. 3 Even those with significant joint damage will benefit from mild to moderate activities, such as walking, bicycling, or running in water.
Who is Robert Laprade?
Robert LaPrade, MD, PhD has specialized skills and expertise in diagnosing and treating complicated knee injuries. He has treated athletes at all levels, including Olympic, professional and intercollegiate athletes, and has returned numerous athletes back to full participation after surgeries. Recognized globally for his outstanding and efficient surgical skills and dedication to sports medicine, he has received many research awards, including the OREF Clinic Research Award considered by many a Nobel Prize in orthopedics. Dr. LaPrade is one of the most published investigators in his field, and many of the surgeries that he has developed are now performed worldwide and recognized as the “gold standard” for the treatment of complex knee injuries.
What is the recovery process for articular cartilage?
The recovery process and rehabilitation requirements vary significantly among the different operative procedures used to repair articular cartilage damage. The patient’s commitment level to the rehabilitation process is an important factor in determining which treatment may be the best choice.
Does articular cartilage heal?
Unfortunately, articular cartilage does not heal with normal replacement cartilage tissue. When it does heal, it is usually a fibrocartilage tissue layer that heals, which may or may not be functional over the long term.
What is the procedure to replace cartilage?
This would mainly happen in smaller areas of a cartilage defect. Other means can include growing one’s cells and replacing it, called a MACI procedure, or having a fresh donor graft from a recently deceased young donor and replacing the whole bone and cartilage unit, called a fresh osteoarticular allograft.
What is the function of articular cartilage?
Simply put, the function of articular cartilage is to serve as a shock absorber with activities. In addition, it allows for smooth movement, and is incredibly complex in its overall function. Any damage to the cartilage itself is called arthritis.
What is the most common procedure for chondral defects?
The most commonly performed procedures for treating chondral defects are Shaving and Microfracture. Shaving or Debridement. This arthroscopic technique has been popular for 20 years and has had very satisfactory results for over 75% of patients.
What is a chondral injury?
An articular cartilage injury, or chondral injury, may occur as a result of a pivot or twist on a bent knee, similar to the motion that can cause a meniscus tear. Damage may also be the result of a direct blow to the knee. Chondral injuries may accompany an injury to a ligament, such as the anterior cruciate ligament.
What is the cartilage on the knee?
There are two types of cartilage in the human knee: Meniscus cartilage - This is the cartilage most commonly referred to when the term "torn cartilage" is used. These two rubbery shock absorbers sit between the upper bone of the thigh ( femur) and the large bone in the lower leg ( tibia ).
How long does it take for cartilage to grow?
It takes two to three years for these new cells to mature completely. This procedure is used if there is bone damage in combination with articular cartilage defects.
What is grade 1 cartilage?
Grade I - The cartilage "blisters" and becomes soft in the earliest form of damage. Grade II and III - As the condition worsens, the cartilage may become fibrillated (it has a shredded appearance). The grade of injury depends on the size of the involved area and how much of the cartilage thickness is worn down.
Why does osteoarthritis hurt?
Painful osteoarthritis develops when this smooth, gliding surface on the end of the bone has lost its cushioning, deformity develops, and bone rubs on bone. Damage may occur as the result of a sudden injury or wear and tear over many years. There are some people with damaged articular cartilage who display few symptoms and may not develop ...
Structure
- The ends of the femur and tibia, the knee bones, are capped with a gristle which is called cartilage. Cartilage is a remarkable organ because it can withstand a significant amount of impact and shear-type activities over time.
Causes
- An articular cartilage injury, or chondral injury, may occur as a result of a pivot or twist on a bent knee, a direct blow to the knee, or wear and tear as a patient gets older. In some cases, chondral injuries may accompany an injury to a ligament such as the anterior cruciate ligament (ACL). Small pieces of the articular cartilage can break off and float around in the knee as loose bodies…
Clinical significance
- When cartilage becomes damaged, it is called chondromalacia. This is basically a kind term for osteoarthritis. Even young patients can develop chondromalacia, which means that they have damage to the cartilage on the ends of their bones. Once damage occurs, it is invariably progressive and can lead to pain and swelling, which are the main signs of osteoarthritis, and th…
Symptoms
- The symptoms of a chondral injury are not as obvious as those of a meniscus tear or ligament injury.
Diagnosis
- The majority of patients who have problems with chondral defects of the knee have pain and swelling with activities. This is a sentinel sign that we rely on for those patients that are symptomatic. Diagnosis of these problems can be used with standing x-rays which may show joint space narrowing, or the use of a high-quality MRI scan. Many of the lower signal strength M…
Treatment
- The treatment of chondral defects of the knee can depend upon the location and size of the defect. In general, those that are on the end of the thigh bone, the femur, are the ones that are easiest to treat and have the best outcomes. Those on the tibia and kneecap (patella) are harder to treat and the results are not as reliable. For those patients who have a surface defect of the c…
Scope
- The recovery process and rehabilitation requirements vary significantly among the different operative procedures used to repair articular cartilage damage. The patients commitment level to the rehabilitation process is an important factor in determining which treatment may be the best choice.
Prevention
- While there is not one specific thing that can prevent cartilage damage in the knee, there are a few measures that can be taken to delay the process.
Research
- Most studies of the effects of glucosamine and chondroitin have been done in animals, and most of the reported effects are based on hearsay rather than scientific evidence. Human studies are currently underway and reported results do show some promise that these substances can relieve the inflammation caused by arthritis in 60-70% of patients. It is doubtful, however, that they can …