Understanding a silent but decisive attack
Knee cartilage damage is a common but often underestimated condition affecting the joint. Often asymptomatic for a long time, it can nevertheless have significant consequences for mobility, daily comfort, and the long-term health of the knee. Whether caused by trauma or progressive wear and tear, these lesions must be recognized and treated early to preserve joint function and reduce the risk of osteoarthritis.
Articular cartilage: an essential role in knee function
Articular cartilage is a smooth, flexible, and strong tissue that covers the ends of bones at the joint. In the knee, it lines the femur, tibia, and the back of the patella. Its role is fundamental: it allows for smooth gliding between bone surfaces and acts as a shock absorber by distributing mechanical stresses.
Unlike other tissues in the body, cartilage has few blood vessels and nerve endings. This characteristic explains both its low healing potential and the sometimes late onset of symptoms. A cartilage lesion can thus evolve for some time before becoming painful.
What is meant by cartilage lesion?
Cartilage lesions correspond to a more or less profound alteration of the articular cartilage. They can take different forms, ranging from simple softening to complete loss of cartilage with exposure of the underlying bone.
We generally distinguish between:
- superficial lesions, which affect the outer layer of cartilage,
- deep lesions, which can extend down to the bone,
- localized lesions,
- diffuse damage, often associated with generalized wear and tear.
Their severity depends not only on their depth, but also on their location and extent.
Origins of knee cartilage damage
Cartilage lesions can have various, often intertwined, causes.
Traumatic causes
Direct or indirect trauma can damage the cartilage in the knee. A violent impact, a fall, a sprain, or a sports injury can cause an acute lesion, sometimes associated with other injuries such as ligament or meniscal tears. In athletes, these lesions sometimes go unnoticed initially, masked by the pain of the original injury.
Gradual wear
Over time, cartilage can gradually deteriorate under repeated stress. This wear is exacerbated by:
- age,
- overweight,
- certain abnormalities of the knee axis,
- activities that put excessive strain on the joints.
This degenerative process can progress to osteoarthritis if no measures are taken to slow down the deterioration.
What are the symptoms of cartilage lesions?
Symptoms vary depending on the location and extent of the lesion, but some signs are particularly suggestive. The pain is often progressive and may appear during exertion, then persist at rest as the lesion worsens. It is sometimes described as deep or poorly localized.
Patients may also present with:
- repeated joint swelling,
- a feeling of stiffness, especially after a period of inactivity,
- a limitation of the range of motion,
- sometimes sensations of blocking or cracking.
These symptoms indicate joint pain that should not be ignored, even if the pain seems moderate at first.
When should you consult a doctor if you suspect cartilage damage?
A consultation is recommended in cases of persistent knee pain, especially if accompanied by repeated swelling, unusual stiffness, or limited range of motion. For athletes, discomfort that persists despite rest or recurs upon resuming activity should also prompt a consultation to ensure early diagnosis and appropriate treatment.
How to make the diagnosis?
The diagnosis is based on a detailed interview and a targeted clinical examination. The healthcare professional seeks to understand the context in which the symptoms appeared, their progression, and their impact on daily activities.
Imaging plays a key role. MRI is the gold standard for assessing the condition of articular cartilage. It allows for evaluation of the depth of the lesion, its location, and the presence of associated damage. In some cases, arthroscopy may be recommended, both as a diagnostic and therapeutic tool.
The principles of care
The main objective of the treatment is to preserve the jointto relieve symptoms and slow the progression towards more severe cartilage degradation.
Conservative treatment
In many cases, non-surgical treatment is preferred as a first-line approach. It is based on:
- the adaptation of physical activities,
- pain and inflammation management,
- rehabilitation aimed at strengthening the muscles around the knee,
- the correction of adverse mechanical factors.
This approach aims to reduce the stress on the damaged cartilage and improve functional comfort.
Surgical options
When symptoms persist despite appropriate treatment, surgery may be considered. Techniques vary depending on the type of lesion and the patient's profile. Their aim is to stimulate cartilage repair or restore a more functional joint surface.
Why early intervention is essential
Cartilage lesions have significant potential for progression. Without appropriate treatment, they can gradually worsen and lead to knee osteoarthritis, characterized by diffuse cartilage destruction and more pronounced functional loss.
Early intervention allows for:
- to sustainably improve the quality of life.
- to limit the worsening of the injuries,
- to preserve mobility,
- to delay, or even prevent, the onset of osteoarthritis,
- to sustainably improve the quality of life.
From cartilage damage to knee osteoarthritis
Damage to the cartilage in the knee can, over time, contribute to the development of osteoarthritis, although this progression is not inevitable. When the cartilage is damaged, its ability to protect the joint and absorb stress decreases, which increases friction between the bone surfaces.
Without appropriate treatment, this weakening can worsen due to repeated mechanical stress, knee instability, or excess weight. Osteoarthritis then corresponds to a more diffuse and lasting damage to the cartilage, associated with a progressive deterioration of the entire joint. Early treatment of cartilage lesions aims precisely to limit this risk and preserve knee function in the long term.
Conclusion
Knee cartilage damage represents a fundamental impairment of the joint, often subtle at first but potentially serious. Whether caused by trauma or progressive wear and tear, it requires careful attention. Early diagnosis and appropriate treatment are key to preserving the knee and maintaining satisfactory joint function in the long term.
