What It Is

Articular cartilage is the smooth, white tissue that covers the ends of bones in the knee joint, allowing them to glide over each other with minimal friction. An injury to this cartilage can occur from trauma, repetitive stress, or degenerative conditions like osteoarthritis. Unlike other tissues in the body, articular cartilage has a limited ability to heal on its own because it lacks a direct blood supply, making injuries to this tissue particularly challenging to treat.

Signs & Symptoms

  • Pain or aching in the knee, particularly with movement or weight-bearing activities
  • Swelling or stiffness in the joint
  • A grinding or catching sensation in the knee
  • Limited range of motion
  • Knee instability or “giving out” during activity

Diagnosis

Dr. Romanelli will begin with a physical examination to assess the knee for signs of cartilage damage. Diagnostic imaging, such as MRI, is often used to confirm the extent of the injury and to evaluate the overall health of the knee joint. In some cases, an arthroscopy (a minimally invasive procedure) may be performed to get a more detailed look at the cartilage and other structures inside the knee.

Treatment

The treatment approach for articular cartilage injuries depends on the severity and location of the damage, as well as the patient’s overall knee health. Early intervention is crucial to prevent further deterioration of the joint. Treatment options range from conservative management to surgical repair, aimed at restoring smooth joint function.

Non-Surgical Treatment

In less severe cases, non-surgical options can help manage symptoms and improve joint function. These treatments include:

  • Rest and Activity Modification: Reducing activities that aggravate the knee can help protect the cartilage from further damage.
  • Medications: Anti-inflammatory medications may be prescribed to reduce pain and swelling.
  • Physical Therapy: Strengthening the muscles around the knee helps support the joint and reduce the load on the damaged cartilage.
  • Injections: Corticosteroid or hyaluronic acid injections may be used to reduce inflammation and improve joint lubrication.

Surgical Procedure

For more severe injuries or when non-surgical treatments are ineffective, surgical intervention may be necessary. Surgical options for repairing or regenerating damaged cartilage include:

  • Microfracture: This procedure involves creating tiny holes in the bone beneath the damaged cartilage to stimulate new cartilage growth.
  • Osteochondral Autograft Transplantation (OATS): Healthy cartilage is taken from a non-weight-bearing area of the knee and transplanted to the damaged area.
  • Autologous Chondrocyte Implantation (ACI): Cartilage cells are harvested from the patient, cultured in a lab, and then re-implanted into the damaged area to promote new cartilage growth.
  • Arthroscopic Debridement: Damaged or loose cartilage fragments are removed to smooth the surface of the joint, relieving symptoms and improving function.

Physical Therapy

Physical therapy is a critical component of recovery following an articular cartilage injury, whether treated surgically or non-surgically. Rehabilitation focuses on restoring range of motion, strengthening the muscles around the knee, and improving joint stability. Dr. Romanelli works with physical therapists to design personalized rehabilitation programs, ensuring a smooth and effective recovery that helps patients return to their normal activities.