Case Summary  |  Effects and Treatment of Articular Cartilage Damage

About two years ago I started feeling slight pain in my right knee. It had been sore for a while but I figured it was just a sore joint from overuse/misuse and I ignored it. However, after increasing pain when running, going up stairs, or even walking for long periods of time, it became harder to ignore. Eventually my knee started to swell slightly and I knew something was seriously wrong.

After explaining my symptoms to my doctor, he tested for the most common knee problems: damage to my ligaments (which I figured it was as I have been swimming on a daily basis for years), or a problem with my meniscus. When neither of those tests showed anything irregular, my doctor suspected cartilage damage. I was then faced with a difficult decision: if I wanted to have an arthroscopy test. Of course, arthroscopy isn’t like a regular test; it is an actual surgery that involves making a small incision and inserting a scope into my joint. Although this test is, to say the least, undesirable, my doctor told me he had a very strong suspicion that I had articular cartilage damage but in order to treat it he needed to confirm and this was the best way to pinpoint if this was it or not. I did have the choice of trying an MRI scan but it isn’t as accurate, it was going to be expensive, as well as time consuming. It was obvious that the best choice was arthroscopy.

Although my nerves nearly killed me, the procedure wasn’t as bad as I thought. It wasn’t too painful and was very quick. Furthermore, it gave me an answer to my pain, and in fact, it was articular cartilage damage. What exactly is this condition? It is basically damage or deterioration of cartilage, in my case in the joint of my knee. This can be caused by a traumatic fall or injury, or wear and tear over time. The damage causes there to be soft spots or blisters on the cartilage, tears, and in extreme cases lesions. The cartilage cannot repair itself enough to be normal again and cushion the joint like it is intended to, thus an operation is needed to repair the cartilage.

When articular cartilage damage is diagnosed, it is rated on a scale of 0-4, 0 being the least damage and 4 being the most. Although mine was only between two and three, if cartilage damage is not treated it can lead to dangerous consequences such as tears all the way through the cartilage and bone rubbing on bone. This would not only be very painful, but would cause many more problems in time. It was apparent this needed to be repaired sooner than later, especially if I was to continue swimming.

I had an arthroscopic surgery performed in which they re-aligned my knee to a stronger part of cartilage and mended the tears in the existing cartilage. Although this surgery helped soothe the pain and prolong further deterioration, it is not a permanent fix. Continuous wear and tear to the cartilage will, more than likely, lead to a knee replacement sometime in my future. But for now, I have not experienced any pain since the surgery and am doing well. Of course, the thought of damaged cartilage to my knee is always in the back of my mind and it is something that will affect my life forever.