What is articular surface damage?
A special cartilage known as the articular cartilage forms the surface of a joint.
It is the smooth white shiny layer covering the surfaces of the ends of the bones in the knee joint. This surface does not have a blood supply, so when it gets damaged it cannot repair itself.
Damage to the joint surface can happen following an injury when a piece can be broken off. It can also happen due to conditions such as osteochondritis dessicans or more gradually with osteoarthritis and from simple wear and tear.
What are the symptoms of articular surface damage?
The symptoms can vary depending on the cause. They may come on quickly following an injury or more slowly as with wear and tear. Damage to the articular cartilage usually causes pain, swelling, clicking, catching, giving way or locking.
How is articular surface damage diagnosed?
Your surgeon or physiotherapist should be able to tell if you have this condition from your symptoms and by examining your knee.
An X-ray or MRI scan will usually be required to help confirm the diagnosis.
How is articular surface damage treated?
The first part of treatment involves things you can do on your own to reduce your pain. To ease your symptoms, you can:
Rest your knee and avoid activities or movements that make the pain worse.
Put ice on the outside of your knee when it hurts or after activities that cause pain. You can put a cold gel pack, bag of ice, or bag of frozen vegetables on the painful area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and your skin.
Take a pain-relieving medicine. Over-the-counter medicines include paracetemol or ibuprofen.
There are different surgical treatments depending on the cause of the damage. For smaller areas of joint surface damage that does not involve the full thickness of the articular cartilage, the damaged surface can be “smoothed” using a technique called radiofrequency chondroplasty. A small probe is inserted into the knee during a knee arthroscopy (Key-hole surgery). This uses electric current to create a “plasma field” which shrinks the damaged cartilage and makes it smooth. This can prevent further damage to the joint surface.
If the articular surface damage goes all the way down to the bone, but only involves a small area then keyhole surgery techniques to try to re-cover the surface can be used. These include Microfracture and Autologous Chondrocyte Transplantation, a technique where your own cartilage cells are implanted into the defect to encourage growth of new cells to recreate the surface of your joint.
If the joint surface damage is widespread as is the case in osteoarthritis, then some times joint replacement is the only surgical option.
Can articular surface damage be prevented?
To help prevent articular surface damage it’s important to keep healthy and lead an active lifestyle. Some people are more prone than others to develop problems with their joints but to prevent the symptoms getting worse you could consider lifestyle changes such as;
Avoiding running long distances especially on hard ground
Make sure you change your trainers when they wear out
Keep the muscles around your knee strong
Stretch 3-5 times a week
Consider knee supports for certain activities
It is important to get advice from your doctor, physiotherapist or knee surgeon if you develop symptoms in your knee sometimes if caught early further damage can be prevented. For further advice contact My Knee Doc.
Call 0161 4646399 today to arrange a consultation with Mr Gareth Stables.