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There are two types of cartilage in the knee – meniscus and articular.

1. Meniscus injury

The meniscus acts as a shock absorber during weight-bearing activities and helps to maintain knee joint stability. A meniscus tear is a common cartilage injury.

Causes

  • A meniscus tear can be caused during a contact or non-contact activity when a weight-bearing knee moves or twists suddenly.
  • A meniscus tear 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

  • Made on case history and clinical examination.
  • An MRI may also be useful for diagnosing a meniscus tear.

Treatment

  • 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 knee 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 the 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 knee 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

  • Rest, ice and compress should be the first course of treatment upon cartilage injury.
  • Crutches can also be used to ease pressure on the sore knee, followed by physiotherapy, when the knee 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.

Surgical options​ for knee ​cartilage injuries

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 the 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.

Read on for more information on knee osteoarthritis.

Ref: S13