Knee cartilage damage

A common type of injury that can be caused suddenly from a sports injury or come on gradually with conditions such as arthritis.

What is knee cartilage damage?

The bones of your knee joint are coated with a layer of slippery tissue called cartilage, which reduces friction as the bones move over each other. Cartilage can be damaged or torn as a result of an accident or conditions, such as arthritis.

Minor cartilage damage can get better on its own after a few days, although more serious injuries or conditions will need treatment.

Cartilage has very little blood supply, meaning it is hard for it to repair itself. Surgery is usually the only option for more serious damage.

Knee cartilage damage can be caused by a sudden twisting movement or a direct impact to the knee – both of which happen in sports such as rugby, squash, football or skiing. 

Arthritis is a common cause of knee cartilage damage. There are two main types of arthritis: 

  • osteoarthritis – a degenerative condition that wears away bone and cartilage
  • inflammatory arthritis, including rheumatoid arthritis – an inflammatory disease-causing swelling and stiffness in your joints, which can damage the bones and cartilage

The symptoms of knee cartilage damage are similar to other common knee injuries: 

  • joint pain – this may continue even when resting and worsen when you put weight on the joint 
  • swelling – this may not develop for a few hours or days 
  • stiffness 
  • a clicking or grinding sensation 
  • the joint locking, catching, or giving way 

Diagnostic tests for knee cartilage damage

Many knee conditions that have similar symptoms, and the damage can be done in very similar ways (sudden twisting or wrenching, blow to the knee, or arthritis).

Because of this, your doctor will carefully examine your knee and will often recommend an MRI scan and/or weight bearing X-rays to determine the cause of the problem.

Treatment for knee cartilage damage

Non-surgical options

To manage pain and swelling in the days immediately after an injury:

  • Take over-the-counter anti-inflammatories (eg ibuprofen).
  • Ice your knee two to three times a day, for 20 minutes at a time.
  • Elevate your leg as much as possible.
  • Support your knee as it recovers by wearing a knee brace.

One of our physiotherapists can also give you exercises to help regain motion and build up muscle strength and flexibility around the knee.

Occasionally, you may be offered supplements such as glucosamine, chondroitin, and omega 3, which may help in preserving the rest of the cartilage. 

Surgical options

If your cartilage damage is severe or not responding to physiotherapy, your orthopaedic surgeon might recommend surgery.

  • Keyhole surgery – Your surgeon repairs damaged cartilage by inserting surgical instruments through small cuts in your knee. The operation is carried out using a tiny video camera inserted into your knee and a monitor. Cartilage repair can involve shaving or cutting off ragged edges of torn tissue. If the cartilage doesn't need replacing, your surgeon may drill small holes in the surface of the bone to encourage the cartilage to re-grow in place. In some cases, cartilage from another part of your body can be grafted onto the bones.
  • Open surgery – In some cases, your surgeon will operate by making a larger incision to open up the entire knee joint and repair the cartilage using autograft, allograft, scaffolds, and/or chondroplasty.

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