Knee cartilage injuries can occur due to various causes and can lead to pain, swelling, and functional limitations. This is an overview of the causes, symptoms, and treatments for knee cartilage injuries:
Causes
- Trauma: Direct blows to the knee, such as during sports-related activities or accidents, can cause cartilage injuries.
- Degenerative Conditions: Wear and tear over time, as seen in conditions like osteoarthritis, can lead to cartilage damage.
- Repetitive Stress: Activities that involve repetitive impact or stress on the knee joint, such as running or jumping, can contribute to cartilage injury.
- Poor Alignment: Abnormalities in the alignment or mechanics of the knee joint can put excess stress on specific areas of the cartilage, leading to damage.
Symptoms
- Knee Pain: Pain is a common symptom of cartilage injuries. It may vary in intensity and may worsen with activities that involve knee movement or weight-bearing.
- Swelling: Cartilage injuries can cause knee swelling, which may be accompanied by warmth and redness in some cases.
- Joint Stiffness: Stiffness in the knee joint, particularly after periods of inactivity, can be experienced.
- Clicking or Catching Sensation: Some individuals may feel a clicking or catching sensation within the knee joint during movement.
- Restricted Range of Motion: Cartilage injuries can lead to limitations in the ability to fully bend or straighten the knee.
Treatments
The appropriate treatment for a knee cartilage injury depends on various factors, including the severity, location, and extent of the damage. Here are some common treatment options:
Non-surgical Treatments
- Rest and Activity Modification: Limiting or avoiding activities that worsen symptoms can help alleviate stress on the injured cartilage.
- Physiotherapy: A physiotherapist can design exercises to strengthen the muscles around the knee, improve joint stability, and promote healing.
- Pain Management: Over-the-counter pain relievers and anti-inflammatory medications can help manage pain and reduce inflammation.
Surgical Treatments
Minimally Invasive Procedures:
- Arthroscopy: In cases where the cartilage injury is repairable, arthroscopic surgery may be performed. This procedure involves using a small camera and surgical instruments to visualise and treat the damaged cartilage.
- Microfracture: This technique is used to stimulate new cartilage growth by creating small holes in the underlying bone. This procedure encourages the formation of a healing tissue called fibrocartilage.
- Bone marrow aspirate concentrate (BMAC): See below for more information on BMAC.
- Cartilage Transplantation: In more severe cases, where the cartilage damage is extensive, transplantation of healthy cartilage from another part of the body or a cadaveric donor may be considered.
- Autologous Chondrocyte Implantation (ACI): ACI involves harvesting healthy cartilage cells from the patient’s knee, culturing them in a lab, and then surgically implanting them into the damaged area to promote cartilage repair.
- Osteochondral Autograft or Allograft Transplantation: This procedure involves transplanting small plugs of healthy cartilage and underlying bone from a non-weight-bearing area of the knee (autograft) or a donor (allograft) to replace the damaged cartilage.
BMAC, or Bone Marrow Aspirate Concentrate, is a regenerative treatment option that has been used for cartilage repair. It involves the extraction of bone marrow from a patient’s own body, typically from the hip or other bone marrow-rich areas. The bone marrow aspirate contains a variety of cells, including mesenchymal stem cells, which have the potential to differentiate into various types of cells, including cartilage cells.
Here’s an overview of the process and potential benefits of using BMAC for cartilage repair:
Procedure:
- Bone Marrow Aspiration: The patient undergoes a minimally invasive procedure to extract bone marrow from a suitable donor site, such as the hip bone.
- Concentration: The extracted bone marrow is then processed to concentrate the cells, typically by using a centrifuge or other specialised equipment. This concentrates the mesenchymal stem cells and other growth factors present in the bone marrow aspirate.
- Injection or Surgical Placement: The concentrated BMAC is then injected directly into the site of cartilage injury or may be applied during a surgical procedure, depending on the extent and location of the cartilage damage.
Potential Benefits:
- Regenerative Potential: BMAC contains a rich source of mesenchymal stem cells, which have the ability to differentiate into cartilage cells and promote tissue regeneration.
- Anti-inflammatory Effects: BMAC also contains various growth factors and cytokines that can help reduce inflammation and support the healing process.
- Minimally Invasive: BMAC procedures are typically minimally invasive compared to more extensive surgical interventions, such as cartilage transplantation or knee replacement surgery.
- Autologous Source: BMAC utilises the patient’s own cells, reducing the risk of immune rejection or transmission of diseases.
- Potential Long-Term Benefits: Studies have shown promising results with BMAC for cartilage repair, with improvements in pain, function, and cartilage quality observed over the long term.
The choice of treatment depends on several factors, including the individual’s age, activity level, overall health, and the specific characteristics of the cartilage injury. Consulting with an orthopaedic specialist is essential to determine the most appropriate treatment plan based on a comprehensive evaluation of the knee and an individual’s unique circumstances.
