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