Is one cartilage defect different from joint wear?

Does chondral defect mean one damaged cartilage spot?

Yes. In a scan report, chondral defect means damage limited to one area of cartilage.

Osteochondral defect means that same spot also includes the bone underneath. Your report won't always say how deep the damage goes or what caused it.

How is arthritis wear different?

Arthritis can affect the whole joint, not one patch. Cartilage thins, bone changes, and nearby tissue may wear too.

Fixing one spot can't reset the entire joint. That is why the kind of wear changes which care may help.

Can QC Kinetix help me sort it out?

A consultation starts with your report and an exam. QC Kinetix offers regenerative treatments, its term for non-surgical office care using material taken from your body.

One option uses a prepared part of your blood in the joint. The clinician can discuss this care for soreness due to joint wear.

What if the defect does not hurt?

A damaged spot that causes no soreness may only need watching. You can track swelling, motion, and any new catching.

Get another exam if the joint starts giving way. Seek prompt care if it gets stuck and won't straighten.

Don't judge your need for care by one report word. Ask which area is worn and whether the exam tied it to your limits.

The report's name won't tell you how much care you need. Daily soreness, swelling, and the exam matter more.

Sources

1. A JBJS evidence-based review of chondral lesions of the knee sets management by lesion size, location, limb alignment and rotation, and patient demand rather than by product: osteochondral autograft transfer is described as durable and predictable for smaller lesions (under 2 cm2) in young active patients, while lesions of 2 cm2 or more are typically treated with osteochondral allograft transplantation, particulated juvenile articular cartilage, or matrix-associated chondrocyte implantation, with favourable mid- and long-term results reported for allograft or MACI in large lesions of 3 cm2 or more.

   Dekker TJ, et al. — Chondral Lesions of the Knee: An Evidence-Based Approach.. J Bone Joint Surg Am, 2021. DOI: 10.2106/JBJS.20.01161.

2. In a meta-analysis of 63 studies covering 5,397 knees of 4,751 adults with NO symptoms and no injury, the pooled prevalence of cartilage defects on MRI was 24% (95% CI 15% to 34%), rising from 11% in adults under 40 to 43% in adults aged 40 and over. Meniscal tears were present in 10%, bone marrow lesions in 18% and osteophytes in 25%.

   Culvenor AG, et al. — Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis.. Br J Sports Med, 2019. DOI: 10.1136/bjsports-2018-099257.

3. In 1,000 consecutive knee arthroscopies, chondral or osteochondral lesions of any type were found in 61% of patients and focal defects in 19%, with a mean total defect area of 2.1 cm2 and the medial femoral condyle involved in 58%. A single ICRS grade III or IV defect of at least 1 cm2 in a patient under 40 accounted for 5.3% of all arthroscopies.

   Hjelle K, et al. — Articular cartilage defects in 1,000 knee arthroscopies.. Arthroscopy, 2002. DOI: 10.1053/jars.2002.32839.

4. Carbon-14 bomb-pulse dating of tibial plateau cartilage from 23 people born between 1935 and 1997 showed that virtually no replacement of the cartilage collagen matrix happens after skeletal maturity, and that neither osteoarthritis nor tissue damage changed that turnover rate. This is the measurement behind the statement that adult articular cartilage has almost no capacity for self-repair.

   Heinemeier KM, et al. — Radiocarbon dating reveals minimal collagen turnover in both healthy and osteoarthritic human cartilage.. Sci Transl Med, 2016. DOI: 10.1126/scitranslmed.aad8335.

5. Twelve years after arthroscopic diagnosis, dGEMRIC and T2 mapping of 21 knees with full-thickness cartilage defects - 10 repaired at baseline with microfracture or ACI, 11 left untreated or simply debrided - showed no overall increase in cartilage degeneration in the injured knees. Radiographic osteoarthritis changes were present in 13 of the 21 knees but did not correlate with measured cartilage quality.

   Engen CN, et al. — No degeneration found in focal cartilage defects evaluated with dGEMRIC at 12-year follow-up.. Acta Orthop, 2017. DOI: 10.1080/17453674.2016.1255484.