Knee Cartilage Injuries

Knee Cartilage Injury Treatments

Treatments depend on the nature and severity of the cartilage lesion. Common approaches include:

Conservative Treatment

Physiotherapy: Exercises to strengthen the muscles around the knee and improve stability.
Anti-inflammatory drugs: To reduce pain and inflammation.
Intra-articular injections: For example, injection of corticosteroids or hyaluronic acid to relieve pain and improve mobility.

Surgery

Cartilage Repair Surgery: Repair of cartilage lesions using techniques such as microfracture, mosaicplasty or chondrocyte autograft.

Cartilage Repair Surgery

Cartilage repair surgery is a surgical procedure to treat damage to joint cartilage, often performed arthroscopically.

Purpose of Cartilage Repair Surgery
The primary goal of cartilage repair surgery is to restore the surface of damaged or worn articular cartilage in the knee joint (or other joints). Articular cartilage is crucial for smooth, pain-free joint movement, and restoring it can help delay or prevent the development of osteoarthritis.

Common Cartilage Repair Techniques

Microfracture:

Description: This technique is used to stimulate the formation of new cartilage. The surgeon makes small holes in the bone underlying the site of cartilage damage. This allows stem cells present in the bone marrow to enter the damaged area and form new cartilage tissue.
Indications: It is often used to treat small cartilage lesions in well-vascularized areas where the potential for healing is higher.

Mosaicplasty (or Osteochondral Transplantation):

Description: This technique involves taking small healthy cartilage and bone (osteochondral) grafts from a non-weight-bearing area of the knee and transplanting them into the injured area. These grafts are usually taken from the same patient.
Indications: It is suitable for treating larger lesions or specific areas of cartilage where other techniques may not be effective.

Chondrocyte autograft

Description: This procedure involves taking healthy cartilage cells (chondrocytes) from the patient's knee, growing them in the laboratory to multiply, and then reimplanting them into the injured area with a biological scaffold.
Indications: It is used for extensive or deep cartilage lesions where natural cartilage regeneration is insufficient.

Biological Restoration Techniques:

Description: This includes the use of biologics such as platelet-rich plasma (PRP) or collagen matrices to promote cartilage healing and regeneration.
Indications: They are often combined with other surgical techniques to optimize the results of cartilage repair.

Cartilage Repair Surgery Process

Preparation and Anesthesia

The patient is prepared for surgery under general or regional anesthesia, according to the surgeon's recommendations.
Access to the Joint:

Small incisions are made around the knee to allow insertion of the arthroscope and surgical instruments.

Assessment and Treatment

Using the arthroscope, the surgeon assesses the extent and nature of the cartilage lesion.
The specific cartilage repair technique is then chosen based on the size, location and depth of the lesion.

Repair

The chosen technique is implemented to restore the surface of the cartilage.
Grafts are prepared and implanted into the injured area, or perforations are made to stimulate cartilage healing.

Closing

The incisions are closed and a dressing is applied.

Postoperative rehabilitation
Rehabilitation is crucial to optimize the results of cartilage repair surgery.
It includes muscle strengthening, flexibility and proprioception exercises, adapted to protect the treated area while promoting cartilage healing.

Expected Results
The results of cartilage repair surgery vary depending on many factors, including the technique used, the size and location of the lesion, the age of the patient, and compliance with rehabilitation recommendations. Goals include reducing pain, improving joint function, and preventing progression of osteoarthritis.

Possible Complications
Complications may include infections, persistent pain, nerve or vascular damage, and poor cartilage healing results. The risk of complications depends on the specific procedure and the patient's overall health.

In conclusion, cartilage repair surgery is a promising option for treating knee cartilage lesions, aiming to restore joint function and improve the quality of life of patients affected by these problems.