Advertisement

Incidental Cartilage Defect

  • David R. Christian
  • Adam J. Beer
  • Adam B. YankeEmail author
Chapter

Abstract

Focal chondral defects are often identified in the knee either using advanced imaging techniques or at the time of arthroscopy. Many patients with cartilage lesions experience symptoms of pain, clicking, or swelling; however, others remain asymptomatic. The clinical decision of how to manage a chondral defect is often difficult and must be correlated with a patient’s clinical presentation. Additionally, it is critical to weigh the risks and benefits of potential treatments, such as cost, rehabilitation protocol, potential adverse effects, and long-term outcomes when deciding to address a chondral defect. Here we present a case and supporting evidence for the treatment of a 21-year-old male undergoing an anterior cruciate ligament reconstruction with an incidental medial femoral condyle lesion.

Keywords

Chondral defect Asymptomatic Chondroplasty Incidental 

References

  1. 1.
    Curl WW, Krome J, Gordon ES, Rushing J, Smith BP, Poehling GG. Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy. 1997;13(4):456–60.CrossRefGoogle Scholar
  2. 2.
    Oliver-Welsh L, Griffin JW, Meyer MA, Gitelis ME, Cole BJ. Deciding how best to treat cartilage defects. Orthopedics. 2016;39(6):343–50.CrossRefGoogle Scholar
  3. 3.
    Frank RM, Lee S, Levy D, Poland S, Smith M, Scalise N, et al. Osteochondral allograft transplantation of the knee: analysis of failures at 5 years. Am J Sports Med. 2017;45(4):864–74.CrossRefGoogle Scholar
  4. 4.
    Ebert JR, Smith A, Fallon M, Wood DJ, Ackland TR. Degree of preoperative subchondral bone edema is not associated with pain and graft outcomes after matrix-induced autologous chondrocyte implantation. Am J Sports Med. 2014;42(11):2689–98.CrossRefGoogle Scholar
  5. 5.
    Gobbi A, Karnatzikos G, Kumar A. Long-term results after microfracture treatment for full-thickness knee chondral lesions in athletes. Knee Surg Sports Traumatol Arthrosc. 2014;22(9):1986–96.CrossRefGoogle Scholar
  6. 6.
    Gomoll AH, Kang RW, Chen AL, Cole BJ. Triad of cartilage restoration for unicompartmental arthritis treatment in young patients: meniscus allograft transplantation, cartilage repair and osteotomy. J Knee Surg. 2009;22(2):137–41.CrossRefGoogle Scholar
  7. 7.
    Shelbourne KD, Jari S, Gray T. Outcome of untreated traumatic articular cartilage defects of the knee: a natural history study. J Bone Joint Surg Am. 2003;85-A(Suppl 2):8–16.CrossRefGoogle Scholar
  8. 8.
    Widuchowski W, Widuchowski J, Koczy B, Szyluk K. Untreated asymptomatic deep cartilage lesions associated with anterior cruciate ligament injury: results at 10- and 15-year follow-up. Am J Sports Med. 2009;37(4):688–92.CrossRefGoogle Scholar
  9. 9.
    Hubbard MJ. Articular debridement versus washout for degeneration of the medial femoral condyle. A five-year study. J Bone Joint Surg Br. 1996;78(2):217–9.CrossRefGoogle Scholar
  10. 10.
    Scillia AJ, Aune KT, Andrachuk JS, Cain EL, Dugas JR, Fleisig GS, et al. Return to play after chondroplasty of the knee in National Football League athletes. Am J Sports Med. 2015;43(3):663–8.CrossRefGoogle Scholar
  11. 11.
    Messner K, Maletius W. The long-term prognosis for severe damage to weight-bearing cartilage in the knee: a 14-year clinical and radiographic follow-up in 28 young athletes. Acta Orthop Scand. 1996;67(2):165–8.CrossRefGoogle Scholar
  12. 12.
    Anderson DE, Rose MB, Wille AJ, Wiedrick J, Crawford DC. Arthroscopic mechanical chondroplasty of the knee is beneficial for treatment of focal cartilage lesions in the absence of concurrent pathology. Orthop J Sports Med. 2017;5(5):2325967117707213.CrossRefGoogle Scholar
  13. 13.
    Federico DJ, Reider B. Results of isolated patellar debridement for patellofemoral pain in patients with normal patellar alignment. Am J Sports Med. 1997;25(5):663–9.CrossRefGoogle Scholar
  14. 14.
    Pareek A, Reardon PJ, Maak TG, Levy BA, Stuart MJ, Krych AJ. Long-term outcomes after osteochondral autograft transfer: a systematic review at mean follow-up of 10.2 years. Arthroscopy. 2016;32(6):1174–84.CrossRefGoogle Scholar
  15. 15.
    Mithoefer K, McAdams T, Williams RJ, Kreuz PC, Mandelbaum BR. Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis. Am J Sports Med. 2009;37(10):2053–63.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • David R. Christian
    • 1
  • Adam J. Beer
    • 1
  • Adam B. Yanke
    • 1
    Email author
  1. 1.Department of Orthopedic SurgeryRush University Medical CenterChicagoUSA

Personalised recommendations