Introduction to Knee Joint and Cartilage Damage

The knee joint is a complex and vital part of the human body, responsible for supporting nearly the entire weight of the body. It is formed by the meeting of the tibia, femur, and patella, and is surrounded by muscles, ligaments, and cartilage that help provide stability and allow movement. The main muscles surrounding the knee are the quadriceps (front of thigh), hamstrings (back of thigh), and calf (back of lower leg). Ligaments hold the bones together and are integral to stabilizing the knee. The anterior cruciate ligament (ACL) prevents excessive forward movement of the tibia on the femur.

Articular cartilage, a dense, fibrous, connective tissue, covers the end of the bones and allows them to move smoothly against each other with less friction. However, damaged articular cartilage in the knee can lead to pain, swelling, locking, giving way, and grinding sensations (crepitus). Damaged cartilage can be caused by trauma, degenerative changes (osteoarthritis), or inflammatory disorders (rheumatoid arthritis). In cases of mild to moderate cartilage wear, arthroscopic knee chondroplasty, a minimally invasive surgical procedure, can be used to repair damaged cartilage.

What Is Chondroplasty?

Chondroplasty is a surgical procedure that involves removing damaged tissue and smoothing and reshaping damaged cartilage in a joint, most commonly in the knee. The removal of damaged tissue allows for the growth of healthy tissue. By smoothing the surface of the cartilage, the procedure can help reduce joint irritation and improve overall function. Chondroplasty is often used to treat early cartilage damage before more extensive procedures, like cartilage transplantation or joint replacement, are needed.

Purpose of Chondroplasty

Chondroplasty is performed with the goals of:

• Smooth out damaged cartilage

• Prevent further joint damage/breakdown

• Improve function and mobility

• Reduce pain and inflammation

• Follow the orthopedic surgeon's instructions carefully for a successful recovery

• Ensure completed healing with minimal scarring

Common Areas Treated with Chondroplasty

The most common areas where chondroplasty is performed are:

• Knee

• Patella (kneecap)

• Shoulder

• Hip

• Ankle

When Is Chondroplasty Recommended?

Chondroplasty is usually recommended when there is mild to moderate cartilage damage that is causing joint pain, swelling, or limited mobility that has not responded to more conservative treatments like physical therapy, medications, and injections. Chondral lesions, if left untreated, can lead to joint degeneration, making it crucial to address them early. A physical examination is an important part of the pre-surgical process to assess the patient's condition. Common causes of needing a chondroplasty are things like early-stage osteoarthritis, chronic cartilage fraying or softening (chondromalacia), minor cartilage injuries or overuse. A chondroplasty is most effective when it is done before the damage becomes too severe. If done in time, it can help to relieve symptoms and slow further joint damage.

Arthroscopic Knee Surgery and Chondroplasty of Knee Procedures

Arthroscopic surgery, specifically chondroplasty of the knee, is a targeted surgical procedure that is used to repair and smooth out areas of damaged cartilage within the knee joint, most commonly around the patella (kneecap), femur (thigh bone), or tibia (lower leg bone). Thin surgical instruments are inserted through small incisions during the procedure, allowing for enhanced visualization of the knee's structures via an arthroscope. This minimally invasive approach involves a smaller incision, which leads to less tissue damage and quicker healing times. Chondroplasty (knee) is typically part of your surgeon's knee preservation strategy, it is used when damage is localized to one area and before more advanced treatments like a joint replacement are necessary.

How Knee Chondroplasty Is Performed

Knee chondroplasty is one of the most commonly performed knee procedures. It is done using an arthroscopic approach, which means making small incisions around the knee and inserting a tiny camera (arthroscope) to look inside the joint. Specialized surgical tools are also inserted, such as shavers, ablation wands (use radiofrequency), and curettes (scraping tools). During the procedure, the surgeon trims and smooths roughened arthritic joint surfaces. This process helps to address lesions on the cartilage. During the procedure, excess fluid is drained from the joint to facilitate visibility and access for the surgeon. As part of the healing process, new scar tissue forms to cover the area where cartilage has been removed.

Using minimally invasive techniques like this reduces injury to the surrounding area and allows for a more precise repair and quicker healing. For optimal recovery, physical therapy is often recommended to restore your strength, flexibility, and joint stability during the healing process.

Chondroplasty of the Patella Explained

Chondroplasty of the patella is an outpatient procedure that is minimally invasive and used to treat damaged cartilage on the back side of the patella (knee cap). If atypical lesions are detected, a cartilage sample may be taken for further analysis. This procedure employs smaller incisions, which result in reduced trauma and faster recovery. Injury to this cartilage is usually caused by overuse, injuries or arthritis and lead to pain, clicking and grinding sensations during movement of the knee joint.

Why the Patella Is Prone to Cartilage Damage

The patella is particularly sensitive to cartilage damage because it is used during almost all daily activities like walking, squatting, and climbing stairs. With each repetitive movement, the patella slides up and down across the joint. Over time, this can lead to damage, fraying, thinning and softening of the cartilage. Even a small amount of damage to this cartilage can cause pain.

Outcomes for Patella Chondroplasty Patients

For most patients, patella chondroplasty surgery, when done before damage is too extensive, leads to reduced pain, better mobility, and an overall better quality of life. Patients will have three dime sized scars after the procedure. Success rates are better when damage is less severe to begin with. While chondroplasty can smooth out and remove damaged cartilage, it cannot regenerate new cartilage. Although it is not a permanent fix, it can lead to lasting relief. In one study of NBA basketball players, 71% were able to return to play for several more seasons after chondroplasty. It is crucial to follow the orthopedic surgeon's instructions for optimal recovery, which typically includes initial support for a few weeks and a full return to normal activities after a few months.

Is Chondroplasty the Same as Chrondoplasty?

Chondroplasty is the correct spelling for the procedure used to repair damaged cartilage in joints. Chrondoplasty is a common misspelling of this procedure but usually refers to the same procedure. "Chondro" is the Latin root word that refers to things relating to cartilage, whereas "chrondo" is not a medical term.

Related Condition: Chondrosis of the Knee

Chondrosis of the knee refers to the degeneration and articular cartilage damage that lines the surfaces found in your knee joint, especially the underside of the patella and the ends of the leg bones. This condition can result from degenerative conditions such as osteoarthritis. It develops over time from repetitive use, aging, or injuries. For patients who do not achieve relief from initial therapies, surgical treatment like chondroplasty may be considered.

How Chondrosis Relates to Chondroplasty

Chondrosis (chondromalacia) can be treated with Chondroplasty if damage to the cartilage is not too severe. Chondroplasty involves removing damaged tissue to facilitate the growth of healthy cartilage. Chondroplasty is the procedure described above, where cartilage is repaired through small incisions over the joint area, allowing healthy cartilage to grow by creating an optimal environment.

Physical Therapy and Recovery After Chondroplasty

Most patients are able to go home the same day as the procedure. Mild swelling and discomfort are to be expected and usually resolved relatively quickly. Scar tissue forms as part of the healing process, covering the area where cartilage has been removed.

Gentle movement can also begin shortly after surgery, and bearing weight is also allowed after a few days. Physical therapy is usually recommended starting within the first week of surgery to help to restore range of motion and strength.

Full recovery can take from 4-12 weeks, depending on how severe the cartilage damage was and the overall health and activity level of the patient. Following the orthopedic surgeon's instructions carefully, including activity and rehabilitation guidelines, is the best way to recover safely and effectively.

Your doctor will be able to advise you about your recovery. Find out how the experts at Resurgens can get you moving again. Book your appointment today.