The sensitive part in the knee joint
The cartilage in the joints is one of the tissues in the body which does not regenerate very well. As a consequence, the wear and tear, caused by overuse or improper strain, can exceed the regeneration of the tissue. In the long run, this will damage the cartilage in the knee. However, an accident might also lead to such problems. In case of cartilage damage, moving around (e.g., doing sport) will be painful and there might be a painful swelling of the joint.
Causes for cartilage damage in the knee
There are many possible causes for cartilage damage;
Which symptoms are typical for cartilage damage of the knee?
Diagnostics of cartilage damage in the knee
The first step is a clinical examination of the knee. With the help of ultrasound, we can usually find an increased amount of fluid in the joint. The advantage of ultrasound is the fact that the mobility and instability of the joint can be seen and tested.
Based on X-rays it is possible to assess the positioning of the joint when in motion and to show leg axis malalignments. You can see a narrowing of the joint cavity due to reduced cartilage material. Irregularities of the joint surfaces can also be detected.
For the planning of our therapy an MRI is quite often necessary as well. With the MRI, we can clearly see bone problems (oedema) and injuries of the soft tissues (meniscus, cruciate ligament). We can also get a full picture of the cartilage damage in the whole joint. In addition, a digital walk analysis, certain blood tests or an osteoporosis measurement (osteodensitometry) will provide further useful information.
The conservative therapy of cartilage damage in the knee
The aim of our arthrosis therapy is; to mitigate the pain while walking, to reduce the inflammation and to improve the functionality of the joint in order to contain the further development of the cartilage damage.
In our practice we use the following therapies;
Surgery as therapy for cartilage damage in the knee
For minor cartilage damage, floating fragments or a so-called osteochondrosis dissecans, we usually suggest to carry out surgery which will lead to a clear improvement. We use various methods depending on the site of the damage.
During key-hole surgery we insert an arthroscopic camera into the joint. That way we can have a precise look at the defect. For minor defects we use boring or micro-/nano-fracture techniques in the upper bone layer. This results in bleeding that stimulates the bone’s stem cells to form new cartilage. In case of bigger and deep-lying defects, we use membranes that will be inserted into the defect leading to the growing of cartilage cells. Floating fragments which can be trapped or might be rubbing against the healthy cartilage, will be removed. Quite often, there is also damage to the meniscus after accidents. These problems will be taken care of in the same operation.
Dr. Eva Wörenkämper will carry out this type of surgery on-site in our clinic RKM 740, followed by a short-term inpatient treatment.
In case of more severe cartilage damage (gonarthrosis) or leg-axis malalignments, there are further possibilities such as knee endoprosthesis or operation of the leg axes (adjustment osteotomy). We do not carry out such surgery. However, we will, of course, offer our expert opinion and help with the preparation and post-operative treatment of such operations.
Post-operative treatment of cartilage damage in the knee
Depending on the surgery, scope and position of the defect, you will not be allowed to put any weight on your leg. If only floating fragments are removed, it will probably be possible to use your leg.
The post-operative treatment will happen in our practice or you will see the orthopedic surgeon who referred you to us. The treatment involves regular checks on the wound. The threads can be removed within 12–14 days.
We also offer supporting measures such as cryotherapy, kinesiology taping, acupuncture or osteopathy. Dr. Eva Wörenkämper and her team, who are specialists in sports medicine and science, will be very happy to support and guide you regarding the start of your sport activities.
What are the consequences of cartilage damage in the knee?
Minor defects usually grow and can ultimately lead to a complete degeneration of the joint (gonarthrosis). This process causes pain, swelling and an increasing loss of mobility.
What can I do as a preventive measure against cartilage damage in the knee?
The damage is usually caused by sport injuries or a twisted knee trauma. It is therefore critical to recognize instabilities or leg-axis malalignments as soon as possible.
