The mobile joints throughout the body are lined with cartilaginous connective tissue. The knee joint, specifically, contains two kinds of cartilage: articular and meniscal. The lower end of the femur (thigh bone) and the upper end of the tibia (shin bone) are blanketed in a shiny and slippery white tissue known as articular cartilage. The knee joint also houses two crescent-shaped discs of rubbery meniscal cartilage. When healthy, this firm yet flexible connective tissue allows the ends of the bones to easily slide over one another for painless joint movement. Even though these cartilaginous tissues are generally tough, they are still vulnerable to damage and degeneration that can lead to knee joint pain and difficulty with walking. Dr. Frank McCormick, orthopedic knee specialist serving Orlando, Palm Beach County, and surrounding Florida communities, has the knowledge and understanding, as well as substantial experience, in treating patients with cartilage injuries of the knee.
A focal cartilage defect describes a specific area of damage to the articular knee cartilage. This localized area of damage can range from minor weakening in the superficial layer of cartilage to a full-thickness lesion that affects all layers of cartilage down to the bone. Individuals with larger and more severe focal articular cartilage defects are more likely to experience additional symptoms as the area of damage is unable to repair itself.
There are several events, such as a work or sports-related injury, chronic knee joint use, or a traumatic event, that can damage the knee cartilage. A traumatic event can force the knee joint out of its normal position producing a knee joint dislocation. The natural aging process can cause cartilage tissue degeneration over time. Degeneration of the knee cartilage can also occur when the body’s own immune system attacks this tissue. The cartilage can become partially or completely separated from the bone in the event of a violent or abnormal twisting motion. Lastly, a penetrating injury of the knee cartilage can cause bacteria to infiltrate the knee joint leading to an infection of the knee cartilage.
Individuals with cartilage injuries of the knee report similar symptoms regardless of which cartilage tissue is affected. The most commonly reported symptom is varying degrees of knee pain. Some individuals describe a sharp and intense knee pain immediately following an injury whereas others describe a dull ache that has slowly intensified over time. Some other symptoms of cartilage injuries of the knee include:
Dr. McCormick will first obtain a comprehensive medical history and then perform a thorough physical examination of the affected knee joint. Diagnostic imaging studies, such as weight-bearing x-rays and magnetic resonance imaging (MRI), may be requested. These imaging studies allow Dr. McCormick to closely inspect the areas of cartilage damage and identify any damage to the structures surrounding the knee cartilage defects.
Patients may respond well to initial conservative treatments depending on the location, severity, and size of their specific cartilage defect. Rest and ice combined with non-steroidal anti-inflammatory medications (NSAIDs) can provide relief from any pain or inflammation associated with this condition. In the event of persistent symptoms, a corticosteroid injection or other biologic treatment can be administered directly into the knee joint. When appropriate, a physical rehabilitation program will be designed to address the patient’s specific needs such as strengthening the lower leg muscles and improving overall joint flexibility.
Surgical intervention, however, may be necessary for patients that failed to respond to conservative therapies or sustained a complex or severe cartilage injury. Dr. McCormick will review several patient factors to determine the best surgical procedure for addressing the patient’s specific needs. A simple debridement procedure that removes any damaged cartilage fragments may be appropriate for patients with mild knee cartilage injuries. Focal articular cartilage defects generally respond well to a microfracture procedure that induces blood flow into the knee joint. Dr. McCormick may implement a cartilage graft, either from the patient (autograft) or donor tissue (allograft), that has been molded to the patient’s specific cartilage defects.
For more information on meniscus tears of the knee, or the excellent treatment options available, please contact the office of Frank McCormick, MD, orthopedic knee specialist serving Orlando, West Palm Beach County, and surrounding Florida communities.
