Knee Cartilage Damage

Although cartilage exists in different forms throughout the body, the type most relevant to the knee is hyaline cartilage (articular cartilage), which covers the ends of the bones in the knee joint.

• Elastic cartilage is found in the ears and nose; provides flexibility.
• Fibrocartilage is the toughest type, found in spinal discs, hips and pelvis.
• Hyaline cartilage is springy and tough, found in the ribs, windpipe, and joints (including the knee).

Knee cartilage damage are characterised by:

• Knee swelling, warmth, tenderness, and pain.
• Knee stiffness and limited range of motion.
• In severe cases where a piece of cartilage may break off, the knee joint may lock and bleed (hemarthrosis).

Knee cartilage damage can arise from a variety of factors, ranging from sudden injuries to long-term wear and tear. The most common causes include:

• Falls, accidents, or sports injuries.
• Repetitive stress or chronic overuse of the knee joint.
• Age-related wear and tear.
• Obesity, which places extra load on the knee.
• Pre-existing conditions such as osteoarthritis.
• Prolonged inactivity that weakens muscles supporting the knee.

To confirm cartilage damage and assess its severity, doctors rely on a combination of clinical evaluation and imaging techniques. Common diagnostic methods include:

• Physical examination for initial assessment by a clinician.
• Magnetic resonance imaging (MRI) helps ascertain the extent of cartilage damage.
• Arthroscopy, a minimally invasive procedure, uses a small-camera to assist with the examination and repair of the joint.

Based on the extent of the cartilage damage and the overall health of the patients, one or more of the following treatment options may be recommended:

• Non-surgical approaches:
  • Physiotherapy and strengthening exercises to support the joint and improve mobility.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) and, in some cases, steroid injections to relieve pain and inflammation.
  • Awareness regarding injury prevention can also help patients adopt a healthy, low-risk lifestyle.
  • Lifestyle modifications, including weight management and injury prevention strategies.
  • Use of supportive devices (braces or orthotics) in certain cases.
• Surgical approaches: For cases involving severe damage to the knee cartilage, the following surgical options are recommended:
  • Debridement: The removal of dead and/or damaged tissues.
  • Marrow stimulation: The creation of tiny holes within the bone in the affected area so that the bone marrow components that leak into the damaged area form repair tissue.
  • Mosaicplasty: The transplantation of cylindrical plugs of bone and cartilage from the patients themselves into the damaged area.
  • Autologous chondrocyte implantation: The transplantation of chondrocytes from the patient into the damaged area.
  • Advanced surgical options: Partial or total knee replacement, knee implant technology, robotic-assisted surgery, knee joint replacement, and advanced knee surgery that provide faster recovery and improved outcomes for selected patients. 

If left untreated, cartilage damage severely impair the function of the knee joint and cause chronic pain, potentially resulting in conditions like osteoarthritis. 

Consult a doctor if:

• Knee pain, swelling, or stiffness does not improve with rest.
• You experience locking, catching, or instability in the knee.
• A sudden injury causes severe pain and difficulty bearing weight.
• You notice repeated episodes of swelling or joint fluid build-up.

Cartilage damage can be prevented by:

• Maintain a healthy weight to reduce pressure on the knees.
• Warm up and stretch before physical activity.
• Wear appropriate footwear that provides good support.
• Strengthen the muscles around the knee to protect the joint.
• Avoid high-impact activities if you already have knee issues.

For diagnosis and management of knee cartilage damage, consult an orthopaedic surgeon. A physiotherapist may also assist with rehabilitation, strengthening, and safe return to activity.