Cartilage Defects

Cartilage Defects 2017-07-05T13:37:38+00:00

Mechanism of Injury:

  • Traumatic – direct injury from a fall, twisting event
  • Atraumatic – developmental or chronic

Subjective Symptoms:

  • Acute or chronic swelling or effusion
  • Pain with torsional activities, squatting, climbing repetitive motions
  • Localized pain with activities
  • Mechanical Symptoms (locking, catching, instability)

Objective Signs:

  • Swelling, Effusion
  • Tenderness to effected site
  • Crepitus with range of motion
  • Positive McMurray exams
  • X-rays / MRI / CT scans not as conclusive for damage.

Natural History:

Patient may become symptomatic following a traumatic or atraumatic event. Once symptomatic, lesions that are identified require treatment. If conservative measures fail, then surgical options should be discussed to prevent degenerative changes.

NonsurgicalTreatment:

  • NSAIDS
  • Cortisone Injection
  • PRP injections
  • Gluccosamine Injections (Synvisc-One).
  • Physical Therapy (VMO strengthening, ITB stretching)

Maximum Medical Improvement – Varies on severity of injury

Surgical Treatment:

  • Dependent on several factors
    • Size of defect, location (trochlea, condyle) and depth
  • Arthroscopic options:
    • Debriedment
    • Microfracture / drilling
    • Carticel Implantation
    • Osteochondral Grafting – OATS procedure

Maximum Medical Improvement:

  • Arthroscopic (debridement) 6-8 weeks
  • Arthroscopic (microfracture) 4-6 months
  • Arthroscopic
    • Osteochondral Autograft 3-4 months
    • Osteochondral Allograft 4-6 months
    • Carticel and OATS 8-12 months