Ongoing knee problems such as swelling and locking of the knee during activity coupled with pain post activity are common symptoms of injury to the articular cartilage of the knee. Cartilage is a smooth layer that covers the ends of adjoining bones such as the adjoining end surfaces of the femur, tibia bones of the knee joint and the underlying surface of the patella (knee cap). Its function is reduce friction during movement of the knee joint by increasing shock absorption away from the bony surfaces akin to a spongy pad wrapped around a metal Goal post in rugby. There is a lack of blood and nerve supply in cartilage hence it cannot repair itself through the natural inflammation healing process. The lack of nerve innervations means that cartilage will not cause pain unless there is friction on the underlying exposed subchondral bone.
Causes of Knee Cartilage Injuries
Dislocation of the patella (Knee Cap)
Direct Impact against the knee joint
Injuries that cause tearing of knee ligaments and meniscus
Poor tracking of the Patella (knee cap) can lead to unequal loading on the cartilage of knee cap resulting in arthritic cartilage changes.
Signs & Symptoms
Immediate symptoms of acute cartilage injury from knee trauma include;
Swelling due to knee inflammation and internal joint bleeding
Pain when the knee is bent and straightened or fully weight bearing
Creaking noise and locking sensation when actively bending and straightening the knee joint and when attempting to walk
Symptoms of a Long term cartilage injury include –
Clicking or locking sensation during weight bearing knee movement
Knee Pain and swelling during and after weight bearing activities such as walking.
Palpable joint line tenderness and swelling
Treatment & Management
Knee Cartilage injury is a common problem and can worsen overtime. It is best diagnosed through MRI or x-ray scanning and quite often needs to be surgically repaired because of the very poor self healing capacity of cartilage due to lack blood supply. To resume activities like walking and jogging surgery is often required with the rehabilition post surgery being very important. Active bending and straightening the knee joint in a seated position is very important post surgery as this motion enhances articular cartilage healing in the early stage. The Patient should use crutches for the initial early stage period in order to avoid full weight bearing stress of the cartilage.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles.
Contact Number: 0504 26672
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Injury Solutions Clinic
Physiotherapy & Injury Rehabilitation Clinic in Tipperary