What Are Articular Cartilage Defects?

A dense layer of hyaline cartilage covers the surface of the knee joint. This enables the knee to move in a smooth and pain-free manner. Wear and tear of this cartilage which lines the knee can cause locking, instability or pain in the knee. These symptoms is the main reason for people consulting knee surgeons.

What is the Difference between Osteoarthritis and a Cartilage Surface Defect?
  • Cartilage surface defect, known as a chondral flap or osteochondral lesion, occurs when a given cartilage area inside the knee peels off the surface exposing the underlying bone causing pain and instability.
  • Osteoarthritis is when the cartilage, which covers the ends of bones at joints, wears away, and there is bone-on-bone contact.
What Can Be Done To Repair Cartilage Defects?
  • It is best to treat certain cartilage defects non-surgically, particularly if they are picked up in the initial stages and are reasonably stable.
  • Arthroscopy which is a type of keyhole surgery is effective in determining the exact extent of the defect and at times is better than an MRI scan. Using keyhole techniques, minor trimming operations can be undertaken to rectify and smoothen the defect.
  • Over a period of time, a number of cartilage regenerating techniques have developed with different success rates. Micro fracture is one such type of procedure. It works by regenerating growth of new fibrocartilage over the eroded tissue and covers the tissue with tiny membranes, tissue glue, etc. Some other procedures are autologous chondrocyte implantation (ACI) and matrix-induced autologous implantation (MACI) wherein a new cartilage is grown and implanted on the defect. , and newer techniques to cover the defects with artificial surfaces (e.g. HemiCAP, Episurf Medical etc.). HemiCAP and Episurf are relatively new techniques to re-surface the eroded tissue.
    To heal a large and painful surface defect, joint re-surfacing procedures are undertaken.
  • Dr. Rewat Laxman has ample experience in treating cartilage surface defects. He has realized the need to adopt new techniques which are innovative and dynamic but not yet proven along with older techniques which are safe, have withstood the test of time and have impressive success rates. He is of the opinion that cartilage repair is the most dynamic procedure in orthopaedic surgery of the knee.
  • Each patient has his or her own unique problem and they need to be individually assessed advised as per their requirement.