© Roland Jeffery Physiotherapy 2011 Ph (09) 444-7643 Website www.rjphysio.co.nz

Articular Cartilage Injury.

What is an articular cartilage injury? Articular cartilage injury is damage to articular or hyaline cartilage in the knee. Hyaline cartilage is a hard, smooth cartilage that covers the ends of bones and forms the weight- bearing surface of the knee. Its function is to protect the ends of the bones and allow for smooth movement of the joint (See Figure 1). It is different from the meniscus (cartilage), which is the ‘shock absorber’ of the knee. How is it injured? Damage can occur to the articular cartilage on its own as an isolated injury, or in conjunction with other injuries such as knee ligament and meniscus injuries. These injuries often occur in football during tackles or when changing direction suddenly. Damage to the articular cartilage tends to occur at the back of the kneecap in the grove between the condyles of the femur (thigh bone) and the lateral and medial condyles of the femur (See Figure 2). What are the symptoms? The symptoms are like any other knee injury sustained while playing football – swelling, pain, restriction in movement and an inability to train or play. The problem with articular cartilage injuries is that they have a recurrent nature. The injury does not seem to improve with rest and the appropriate rehabilitation. What can the player do? The player should see a sports injury professional for advice. The articular cartilage is unlikely to heal by itself.

Figure 1: Articular Cartilage and Meniscus.

Figure 2: Articular Cartilage Damage.

© Roland Jeffery Physiotherapy 2011 Ph (09) 444-7643 Website www.rjphysio.co.nz

What can a sports injury professional do? If an articular cartilage injury is suspected a sports doctor or physiotherapist will refer the player to an orthopaedic surgeon. An orthopaedic surgeon may order a scan (usually an MRI) or perform an arthroscopy (an operative procedure that looks into the joint) to confirm the diagnosis. Damage can vary from obvious defects in the weight-bearing surface to very minor microscopic damage. If the damage to the articular cartilage is confirmed (by a scan) then a surgeon will most likely operate.

The severity of the injury and the method of management the orthopaedic surgeon decides to utilise will influence the length of time off from soccer and the length of the recovery and rehabilitation process. There are many surgical options available to the orthopaedic surgeon.

Figure 3: Arthroscopy.