The ends of the bony surfaces of our joints are lined with articular cartilage. This applies to the knee as well. An injury to this type of cartilage and the underlying bone is called an osteochondral injury.
Osteochondral lesions can vary in severity from a small defect of crack to a large piece that has broken off inside the knee. Causes of osteochondral lesions are still being studied but trauma, repetitive strain, and a poor blood supply to the area are thought to be contribution factors. Symptoms include pain, swelling, locking, catching, point tenderness and loss of motion. X-rays and MRI can help confirm the diagnosis.
Conservative treatment options include rest, ice, NSAIDS, activity modifications and bracing. Depending of the lesion, arthroscopy is often recommended to repair or remove the fragment. Other surgical options include bone grafting and stimulating blood flow to the damaged area. Bracing and physical therapy are part of the postoperative protocol.
Progressive wear and tear of the articular surfaces of the knee leads to osteoarthritis. It can occur in the medial compartment, lateral compartment, patellofemoral compartment or a combination of the multiple compartments. As the articular cartilage breaks down, the underlying bone can become exposed. This leads to pain, swelling, decreased range of motion, weakening of the surrounding muscles and mechanical symptoms. The diagnosis is made on X-rays and physical exam.
Osteoarthritis Treatment Options
Conservative treatment includes activity modification, physical therapy, NSAIDS, glucosamine, and bracing. Injections of steroids, hyaluronic acid, PRP and stem cells can often provide some relief of the symptoms.
Failure of conservative measures can lead to a partial or total knee replacement. Physical therapy is used to help with range of motion, strengthening, and return to activity.
If you believe you have knee pain from osteoarthritis, consult with an orthopedic surgeon.