Knee

Cartilage damage

uszkodzenie chrząstki stawowejThe cartilage covers the articulating surfaces, and has properties of transferring load and reducing friction. The condition of the cartilage is assessed by the Outerbridge scale

  • 0 – normal cartilage
  • Grade I –cartliage with softening and swelling,
  • Grade II – a partial-thickness defect (crack <1,25mm),
  • Grade III-full crack of the bone (crack >1.25mm),
  • Grade IV –exposed subchondral bone defects

Grades I and II are usually treated conservatively,
III and IV will usually require surgery

Causes

Various physical injuries lead to cartilage damage, impaired limbs, muscle weakness and abnormal joint mechanics.

Symptoms

  • Pain,
  • Joint effusion
  • Limited joint function

How to diagnose cartilage damage?

The diagnosis is based on three elements:

  • I A medical record regarding discomfort, pain, function, type and circumstances of the injury.
  • II Examinations – clinical tests performed by a doctor in the office
  • III Additional examinations such as ultrasound , MRI or X-ray

Injury is diagnosed after the doctor-patient interview, clinical assessment of the knee and a series of physical tests. Diagnostic imaging is useful. An X-ray can exclude any fracture within the joint. Ultrasound and Magnetic Resonance provide an accurate diagnosis of the injury and show the condition of other structures in the knee.

Treatment

Conservative treatment is suggested for patients diagnosed with level I or II of damage. It is multi-level treatment and consists of:

  • rehabilitation
  • pharmacovigliance
  • orthopedic care

Surgical treatment is used in case of serious damage to cartilage, of level III and IV.

Depending on the degree of damage, the extent of the defect and the age of the patients, the following may be experienced:

  • Revitalizing – microfractures,
  • Reconstructive – AMIC – collagen membrane, Scaffolds, cell cultures

One method of treatment of the articular cartilage is regeneration. An alternative method  is endoprosthesis. Nowadays, there are two methods dominated worldwide: the reconstruction of articular cartilage using scaffolds and cartilage reconstruction using scaffolds which stimulate bone marrow stem cells – AMIC.

The AMIC Method

What is AMIC? – Chondro –Gide, namely layered collagen membrane, is applied to the area of large cartilage defect. Previously, however, bone marrow must be slightly drilled and covered as to stimulate bone marrow stem cells. Around the world, orthopedists had been searching for the possibility of adapting such a method of operating to the arthroscopic technique, namely surgery based on small holes and a descriptive camera.

Finally success came for Polish doctors, among whom are orthopedic doctors from Rehasport Clinic.- We have created a technique which allows treatment of large defects in the knee, ankle, and hip to be covered with collagen through small holes.