Cartilaginous lesions

Orthopedic surgeon specializing in the ankle

Cartilages enable the painless movement of joints. They are nourished by the absorption of synovial fluid, and their blood supply is provided by the bone to which the cartilages are attached, known as the subchondral bone.

What is a cartilage lesion?

There are several types of cartilaginous lesions that can be symptomatic: chondromalacia. This is a softening of the articular cartilage. Lesions may involve varying thickness of the articular cartilage, which can even lead to exposing the underlying subchondral bone.

What are the causes?

There are 3 main causes of cartilage injury:

Traumatic cartilage injuries occur during a sprain, a fracture or a joint dislocation, but these traumas can also lead to other complications such as ankle cysts. Degenerative cartilage injuries are worn lesions. As they wear out, the cartilages soften and then gradually lose thickness until they expose the subchondral bone. Osteochondritis lesions can be classified as cartilage injuries, but they are rather a bone problem stemming from a failure of fusion of the ossification centers in children or from a problem of localized bone vascularization in childhood.

What are the treatments for cartilage lesions?

Traumatic cartilage lesions are treated at the same time as a fracture, a sprain, or a joint dislocation. However, it is still necessary to explore the joint in search of cartilage lesions, most often by arthroscopy.

Any joint fracture causes cartilage lesions due to shearing, crushing, and displacement of the joint surfaces. However, not all these cartilage lesions will necessarily be treated, and they do not always become symptomatic. In general, loose cartilage fragments are resected and bone fragments bearing cartilage are repositioned or even fixed.

Degenerative cartilage lesions generally affect both sides of a joint; they correspond to osteoarthritis. Osteochondritis is rather an issue with the bone. Bone affected by osteochondritis is softer and has less mechanical resistance. The treatment involves removing the cartilage to access the bone, curetting it (removing it), and making microfractures in the healthy bone to make it bleed and stimulate its reconstruction. Certain lesions require bone and cartilage grafts; this is known as mosaicplasty.

Cartilage Lesion FAQ

A cartilage injury will persist as long as it is not treated. Cartilage does not have the ability to heal.

Cartilage injuries are managed by an orthopedic surgeon specialized in the affected limb.

Asymptomatic cartilage injuries do not require any specific treatment. The exercises to be performed depend on the type of cartilage injury operated on and the treatment of associated injuries. These exercises are part of a post-operative rehabilitation protocol.