Chondral Injuries of the Knee
A chondral injury is a damage to the cartilage lining the surface of the knee joint. Cartilage is the smooth, rubbery tissue that covers the ends of the bones, allowing the knee to move easily and absorb shock. When this surface is damaged, it can cause pain, swelling, and difficulty with movement.
Causes
Chondral injuries can occur due to:
- A traumatic event, such as twisting or impact during sports
- Repetitive stress or overuse of the joint
- Associated injuries, like ACL tears or meniscal damage
- Degenerative wear and tear over time.
Anatomy
The knee joint is made up of the femur (thigh bone), tibia (shin bone), and patella (kneecap). The ends of these bones are covered with articular cartilage, which allows smooth, pain-free motion.
Unlike other tissues, cartilage has limited ability to heal, as it has very little blood supply.
Chondral Injuries of the Knee
Symptoms
Common symptoms of a chondral injury include:
- Pain deep within the knee joint
- Swelling or a feeling of fullness
- Clicking, catching, or locking sensations
- Stiffness or reduced movement
- Pain that worsens with activity and improves with rest.
Diagnosis
Your doctor will assess your knee and may order:
- X-rays, to check for bone changes or arthritis
- MRI scan, which provides detailed images of cartilage and soft tissue
- Sometimes, arthroscopy (keyhole surgery) may be used to directly view and treat the cartilage surface.
Treatment
Treatment depends on the size, depth, and location of the cartilage injury, as well as your age and activity level:
- Non-surgical management may include:
- Rest, activity modification, and anti-inflammatory medication
- Physiotherapy to strengthen muscles and improve joint biomechanics
- Injections (such as platelet-rich plasma or hyaluronic acid) to reduce pain and inflammation
- Surgical options may be considered for larger or more severe injuries:
- Arthroscopic debridement – smoothing frayed cartilage
- Microfracture – stimulating new cartilage growth by creating small holes in the bone
- Cartilage repair or restoration techniques – such as osteochondral grafting or autologous chondrocyte implantation (ACI) in selected cases.
Recovery
Recovery depends on the type of injury and treatment:
- Minor injuries may improve with conservative care over 6–12 weeks.
- After surgery, return to normal activity can take 3–6 months or longer, depending on the procedure.
Physiotherapy plays a vital role in restoring movement, strength, and joint stability.
Possible Complications
While many patients recover well, potential issues can include:
- Ongoing pain or swelling
- Stiffness or weakness
- Progression to early arthritis if the cartilage damage worsens over time.
When To Seek Help
See your doctor if you experience:
- Persistent knee pain or swelling after injury
- Locking, catching, or giving way of the knee
- Pain that limits sport or daily activities.
