Each year, the ability of MRI to visualize articular cartilage improves, but at present, only major medical centers are able to routinely make substantial diagnoses of articular cartilage injury with MRI alone. X-rays may also help your doctor to indirectly suspect cartilage injury. For degenerative arthritis or chondrosis, your doctor may recommend low impact exercises such as swimming to strengthen the muscles surrounding the knee. A Physical Therapist may be helpful in teaching the proper ways of exercising and strengthening those muscles without overloading the joint and making the problem worse. It is important to consult your doctor before beginning any exercise program.
Since jagged pieces of cartilage caused by chondrosis may irritate the knee, an arthroscopic procedure may wash out the debris and trim away areas of abnormal cartilage that are ready to flake off. This procedure, known as chondroplasty, is a short-term symptomatic treatment that a doctor may pursue during the early stages of chondrosis.
A doctor may be able to reattach an osteochondral or chondral fracture where pieces of the cartilage and/or bone are broken off with wires, screws or pins.
For larger defects in the articular cartilage, your doctor has many options for cartilage restoration. These may range from marrow stimulation, to mosaicplasy or OATS, in which small plugs of bone and attached articular cartilage are placed in the defect. In addition, a doctor may recommend the patient undergo Autologous Chondrocyte Implantation (ACI, or Carticel), in which a patient’s own cartilage cells are harvested and grown in a laboratory and then re-implanted into the damaged area of the knee. Patients may also be able to receive cartilage from a donor cadaver.
Increasing muscle strength in the leg smoothes out loading of the knee joint and may decrease your risk of degeneration. Research continues to examine what factors may protect cartilage.