Cartilage Injury in the Knee: Assessment and Treatment Options

Aaron J. Krych, MD; Daniel B. F. Saris, MD, PhD; Michael J. Stuart, MD; Brittney Hacken, MD

Disclosures

J Am Acad Orthop Surg. 2020;28(22):914-922. 

In This Article

DéBridement/Chondroplasty

Arthroscopic débridement/chondroplasty is a technique in which a loose flap of cartilage that may be causing mechanical symptoms and/or effusions is débrided back to a stable edge. The goal of this technique is to help alleviate any mechanical symptoms and irritation, along with hopefully preventing the propagation of the cartilage lesion from any mechanical stress on the unstable flap.

Benefits of this procedure include the ability for immediate weight bearing with a shorter recovery period. This procedure is a relatively inexpensive treatment option that does not require notable preplanning or multiple stages as other cartilage restoration surgeries do. Studies have shown the procedure to be beneficial regarding pain, physical function, and quality of life when performed in the absence of concurrent pathology.[7] In a study of the National Football League athletes, 67% of patients were able to return to regular season National Football League play after chondroplasty.[8,9] Contrary to this, other studies have shown no benefit to debriding an unstable cartilage flap compared with observation alone in the setting of partial meniscectomy.[10] Unfortunately, the biggest limitation of surgical débridement is that it does not restore normal articular cartilage congruency because it only acts to treat mechanical symptoms from loose chondral flaps. Despite its limitations, this is a good first-line treatment option for patients with smaller cartilage lesions in the absence of concurrent pathology with the benefit of a short postoperative rehab period and certainly can be considered when the main symptom is mechanical in nature.

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