The cartilage of the knee is the layer that covers the bones that are located in the areas of joint contact, including: femur, patella and tibia. The cartilage of the knee has its own thickness, when it wears out, the first signs of osteoarthritis begin to appear.
However, the topic of cartilage injuries is more extensive than everyone imagines, since there are a large number of problems such as: osteochondritis, chondral injury, cartilage ulcer, among others, which can occur in multiple locations within the knee; which tends to generate confusion in the patient before the definitive diagnosis.
Knee cartilage surgery merits individualized and patient-focused decision-making, considering that the type of injury has unique and different characteristics in each case.
The experience of the orthopedic surgeon also plays a fundamental role in the results of the surgery, because the surgical techniques he uses will require a lot of expertise for the cartilage repair to be a success.
We must remember that both orthopedists and other medical professionals are based on the principle of achieving the maximum benefit with the minimum possible harm, this leads us to devise the best treatment strategies for each patient.
The cartilage of the knee is what’s called a “load-bearing cartilage,” functioning as a shock absorber to withstand impact on the knees when walking, running, jumping, lifting, and so on.
When it suffers an injury either due to overweight, excessive pressure, overload, trauma or other external or internal factor, there is no natural way for it to regenerate on its own, which is why people feel more and more pain if they are not treated in a timely manner.
If knee cartilage problems are allowed to advance and a medical solution is not sought, it is likely that in addition to feeling intensified and disabling pain, functional disability, weakness, leg failure, inflammation and stiffness will also appear.
There are many techniques to treat articular cartilage injuries, but in the choice of the most appropriate ones, the characteristics of the injury and the particular conditions of the patient must be considered.
Among the questions that doctors evaluate, we can mention: What type of lesion are we dealing with?, What is the lesion like?, What is its depth?, How big is it?, In what area is it located?, What is the age of the patient (is it a young or old person)?, What activities do they usually perform?, Is they an athlete or sedentary?, Was the injury generated by external causes or is there a hereditary degenerative pathology?.
Once all this information has been assessed, it will be decided which is the right procedure for that particular patient. Some of the most common surgical techniques are:
It is a very common procedure in patients with lesions smaller than 2 centimeters and with little depth. In this surgery, the doctor removes the small fragments of loose cartilage (which have been shed by the damage) to improve the feeling of blockage when walking. Chondroplasty can be accompanied by other methods of stimulation or infiltration, with the aim of promoting the growth of new cartilage in the area of the lesion.
This technique executed through arthroscopy focuses on minimal lesions (less than 3 cm in diameter). The surgery consists of performing controlled micro perforations in the calcified area of the base of the cartilage; These holes will function as a bridge to connect the lesion with the mesenchymal cells that are active under the cartilage. This attachment to the cells will eventually encourage the growth of new tissue that is very similar to the original cartilage of the knee.
This is an open surgery where the doctor removes limited portions of healthy cartilage (from a less demanding area of the same knee) to graft onto the injured area. Generally, this method is used in patients with small lesions (no larger than 2.5 cm) and deep lesions (with damage that can reach the subchondral bone).
Cartilage implantation is a surgical option that aims to prevent the development of severe osteoarthritis, prolong the life of the joint, and stop a more invasive procedure such as prostheses. In a first surgery, a portion of cartilage is extracted that will be used to grow chondrocyte cells for about 4 or 6 weeks, after this time, a second intervention is performed to transplant the chondrocytes on the lesion.
When the damage is not limited to the cartilage but also severely affects the bone, surgery is necessary to remove both the damaged cartilage and bone and replace the injured parts of the knee joint with prostheses.
The wear and tear of the knee cartilage can limit the daily activities of people who suffer from it, therefore, any of the surgeries mentioned above have the same goal in common; slow down joint deterioration and restore mobility so that the patient recovers the functions they had lost.
Recovery time may vary slightly depending on the cartilage surgery you have received. On average, laparoscopic surgeries require at least 4 weeks of total immobilization of the leg while the cartilage grows, additionally, you will need to use crutches for an estimated period of 6 to 8 weeks; At the end of this time and when your doctor approves it, you can start with physical rehabilitation therapy which can last from 3 to 6 months depending on your evolution.
Complex surgeries lead to a longer recovery process, where the patient must rest and avoid standing, bearing weight or walking with the operated leg for a few weeks. The exact time will be stipulated by the treating doctor after routine postoperative check-ups.
Although complications do not usually appear frequently in knee arthroscopy, there is always a minimal chance of risk. In this case, those risks are:
Internal joint bleeding.
Damage to other parts of the cartilage, ligaments, or menisci.
Blood clots in the limb.
If the patient underwent knee replacement surgery, he or she should be aware that these mechanical structures can lead to rejection; This would result in: fever, general malaise, pain, redness in the area of the operation, inflammation and secretion of fluids from the wound.
In the event of any abnormal symptoms, we recommend that you remain calm and immediately contact your treating doctor.
The Panama Clinic, Tower B, 23rd Floor, Office 2315
