Cartilage Restoration and Joint Preservation

The most common complaint from patients suffering from a knee cartilage injury is a constant, dull ache and swelling with activity. With more severe injuries, catching or locking of the joint with motion may occur due to a piece of broken cartilage that is lodged in the joint.

The symptoms of knee cartilage injuries may overlap with other injuries to the joint. In order to reach a diagnosis, Dr. Waterman will conduct a thorough physical examination, compare the injured knee to the other knee and conduct numerous tests to rule out other possible knee injuries. X-rays and an MRI may also be ordered to confirm the diagnosis.
Treatment of a Knee Cartilage Injury

Once a knee cartilage injury has been diagnosed, Dr. Waterman will explain the injury and treatment options. Treatment recommendations are based on the location of the injury, the size and depth of the damage as well as any additional pathology such as ligament injury.

Non-Surgical

A knee cartilage injury is often treated without surgery. Rest, ice, compression and elevation of the knee will assist with the healing process. Dr.Waterman may also recommend a physical therapy recovery program and anti-inflammatory medications to build up strength and mobility and decrease inflammation. Often times injections of cortisone or other biologic agents may help to decrease swelling and improve pain and function.

Surgical

If a non-surgical approach is not beneficial or if the injury is too severe, Dr.Waterman may recommend surgery. Surgery depends on lesion size, injury severity, patient age and activity level of the patient. There are numerous knee surgery options Dr.Waterman can utilize, many with an arthroscopic approach. The most commonly performed procedures are debridement and Microfracture.

• Debridement (shaving): Special arthroscopic instruments are used to smooth the shredded or frayed cartilage. Ideally, this treatment will decrease friction and irritation, reducing the symptoms of swelling and pain.
• Partial Menisectomy: If the meniscus is torn, it may cause pain, catching or other mechanical symptoms. Using special arthroscopic instruments, a portion of the torn meniscus may be repaired or removed to eliminate symptoms.
• Microfracture (marrow stimulation): A surgical technique used to treat damaged areas of articular cartilage in the knee. Small holes are prepared in the bone to allow for blood flow egress to stimulate healing and neocartilage formation
• Allograft transfer: A technique used to replace the damaged areas with a cartilage-bone unit that is procured from a donor. This is usually reserved for large areas of cartilage damage and can be ideal in situations where the underlying bone is damaged.
• Autologous Chondrocyte Implantation (ACI): A technique used to repair defects to the articular cartilage. The procedure involves removing a small piece of cartilage and sending to a laboratory where additional cartilage cells are fostered from the sample. After a waiting period, the new cartilage cells are implanted into the knee by injecting the cartilage cells into the defect. These cells eventually grow into new, healthy cartilage.