Orthopedics-Online

Cartilage flake

What is a cartilage flake?

The human articular surfaces are covered with cartilage and ensure smooth movement of the joint. A cartilage flake, also known as a flake fracture, is a tear off of such cartilage parts from a joint.

The torn off joint body can now move freely in the joint and blockages can lead to pain and restricted mobility. This often happens in sports accidents in the context of shear, rotational and compression loads. The knee and ankle joints are most frequently affected.

You can recognize a cartilage flake by these symptoms

If the torn cartilage fragment is exposed in the joint, it often does not cause any symptoms. In most patients, a cartilage flake therefore often goes undetected. However, it can cause pain when moving around the joint. In the knee, they often occur when bending and rotating. Often there is also a swelling of the joint, as well as entrapment symptoms.

If the cartilage fragment blocks the joint movement, this can lead to movement restrictions, which can also occur very suddenly. If the cartilage flake is not treated, the joint can become inflamed and cause osteoarthritis in the long term.

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Blockages in the joint

Broken cartilage parts can block the joint and lead to restricted mobility. If the cartilage parts attach to the joint surfaces, the original smooth movement of the joint cannot be fully carried out. As a result, there are often symptoms of entrapment.

The size is crucial. Smaller defects rarely lead to blockages in the joint, but larger defects can cause more serious blockages.

Pain

Pain is a typical symptom of a cartilage flake. Patients often report sudden, severe pain in the joint. Mostly these are movement-dependent, depending on the affected joint.

In the knee, they mainly occur during rotation and flexion. There is usually no pain at rest, as the fragments in the joint then do not move.

Read more on the topic: Pain in the joints

Treatment of a cartilage flake

A cartilage flake is usually treated surgically, usually in the form of a reflection of the joint (arthroscopy). In the case of large cartilage flakes, an attempt is made to fix them back in their original place, while smaller ones are removed directly.

The quickest possible re-fixation of the torn cartilage fragment is very important, as the free movement of the fragment in the joint could mechanically crush it and thus no longer fit in its original location in the joint surface. There are different approaches for re-fixation, depending on the type and size of the cartilage flakes. Various cartilage dowels, bone screws or tissue glue, for example fibrin, are used.

An attempt can also be made to fix the fragments using a so-called drilling technique. Small holes in the bone can be used to form a replacement cartilage, which closes the defect in the cartilage. You can also do cartilage bone transplants from other articular cartilage.

In combination with surgical treatment, conservative therapy can also be carried out. The affected joint should be spared until the symptoms are relieved. In the case of severe symptoms, it can make sense to take anti-inflammatory and pain reliever medication (NSAID) such as ibuprofen or diclofenac. For a better healing process, physiotherapy is also recommended to counteract restricted mobility.

Read more on the topic: Cartilage damage

Healing time

The healing time of a cartilage flake depends on the degree of severity and the therapy used.

In the case of smaller defects that can be removed directly by means of arthroscopy, healing and improvement of the symptoms can be expected after surgery. In the case of larger defects that require re-assembly, the cartilage needs some time to fix the re-inserted fragment in its structure in a stable manner. Careful follow-up treatment and further immobilization of the joint for 1-2 weeks are important, until the cartilage is completely healed.

With a cartilage transplant, it takes several months for the replacement cartilage to form.

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forecast

The prognosis for a cartilage flake is usually good. Smaller defects can be treated directly without further complications. Larger defects are an urgent indication for an operation in order to be able to insert the torn fragment again. If this does not succeed and a larger cartilage defect persists, this can lead to long-term pain and restricted mobility and further treatment can result.

If a cartilage flake is not recognized and remains untreated, further cartilage damage can occur and the risk of more serious diseases, such as osteoarthritis, is greatly increased.

Read more on the topic: Symptoms of osteoarthritis

causes

The most common cause of a cartilage flake is injuries in sports, for example in:

Joint injuries
Dislocations and
Torn ligaments

It can also occur in the context of other diseases, such as inflammation of the joint cartilage (synovitis), circulatory disorders of the joint bone (osteochondrosis dissecans), as well as adhesions and tumors in the joint mucosa (chondromatosis).

In rare cases, it can occur as a result of the introduction of foreign material, for example during an operation.

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diagnosis

The first examination of a cartilage flake is carried out by a doctor, in most cases an orthopedic surgeon or trauma surgeon. The doctor first takes a detailed medical history and conducts a physical examination. The doctor can use various functional tests to determine movement restrictions, misalignments and joint instabilities.

The diagnosis of a cartilage flake can only be confirmed by means of ultrasound, x-rays or cross-sectional imaging, such as computed tomography (CT) or magnetic resonance imaging (MRI). Arthroscopy can be performed for further diagnostics and for simultaneous therapy.

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In which joints are cartilage flakes most common?

Cartilage flakes are most common on the ankle and knee joint. On the one hand, this can be traced back to the anatomy of the joints, and on the other hand, sports injuries are most common in these joints.

Read more about the topic here: Cartilage damage to the ankle

Further information

Further information on the subject can be found on the following pages: