Articular Surface
Normal Anatomy
Smooth, continuous cartilage layer coating bone ends
Pathological / Affected Anatomy
Focal defect (chondral pothole) exposing subchondral bone
Conditions
Cartilage Injury
Articular cartilage damage can cause localized pain and catching. This page explains cartilage defects, assessment, and surgical vs non-surgical pathways.
On this page
What is Cartilage Injury?
Articular cartilage is a highly specialized, low-friction tissue lining the bone ends. Cartilage injuries involve localized 'potholes' or focal damage rather than widespread wear. Since cartilage has no direct blood supply, its healing capacity is limited. Wording is cautious: surgical options are considered only when clinically indicated. Suitability depends on defect size, depth, alignment, and symptoms.
This information is for general patient education and does not replace an individual clinical assessment.
Anatomical Overview
Chondral Defect
Localized area of missing articular cartilage exposing subchondral bone.
Chondral DefectPathology
Localized area of missing articular cartilage exposing subchondral bone.
Anatomy Comparison
Healthy vs Affected Joint Comparison
Understanding structural differences caused by cartilage injury.
Comparison DiagramClinical ReferenceJoint Friction
Normal Anatomy
Low friction, pain-free gliding during bending
Pathological / Affected Anatomy
Localized friction, grinding, or catching at the defect site
| Anatomical Feature | Normal Anatomy | Pathological / Affected Anatomy |
|---|---|---|
| Articular Surface | Smooth, continuous cartilage layer coating bone ends | Focal defect (chondral pothole) exposing subchondral bone |
| Joint Friction | Low friction, pain-free gliding during bending | Localized friction, grinding, or catching at the defect site |
Annotated Imaging Example
LKC Imaging Viewer
Arthroscopy · Intra-operative arthroscopic view
Annotations visibleEducational use only
Annotation Reference
- 1Focal Cartilage Defect (Chondral Defect)
- 2Exposed Yellowish Subchondral Bone
- 3Surrounding White Articular Cartilage Edge
Educational Imaging DisclaimerThis imaging example is provided solely for educational purposes. It is not a diagnostic image and does not represent your own anatomy or pathology. All patients require individual clinical examination, history taking, and appropriate investigations to reach a diagnosis. The findings shown may not be present in your case.
Common symptoms
Symptoms vary, and similar symptoms can occur with other knee conditions. Commonly reported signs include:
Localized joint pain, worse with weight-bearing or impact
Intermittent joint swelling or effusion after exercise
Catching, clicking, or locking sensations during knee movements
Reduced range of motion or joint stiffness
Causes and associated factors
The development or onset of this condition can be associated with several mechanical, biological, and lifestyle factors, including:
- Acute impact trauma or falls during sporting activities
- Shearing forces associated with ligament or meniscal injuries
- Chronic localized overloading due to joint misalignment
Urgent symptoms? Read urgent advice.Lincolnshire Knee Clinic does not provide emergency medical care. For life-threatening symptoms call 999. For urgent non-life-threatening advice use NHS 111.
Lincolnshire Knee Clinic does not provide emergency medical care. For life-threatening symptoms call 999. For urgent non-life-threatening advice use NHS 111.
Clinical assessment and diagnosis
A comprehensive clinical assessment is performed to understand the root cause of your symptoms and outline appropriate management options.
- Discussion of injury history, symptoms, and activity levels
- Physical examination checking localized joint line tenderness
- Assessment of ligamentous stability and meniscal signs
- Review of functional limitations in daily activities
A diagnosis should not be made from website information alone.
Investigations
Imaging and other investigations may be recommended depending on clinical presentation. Common assessments include:
High-resolution MRI scan
cartilage sequences) to evaluate defect size, depth, and subchondral bon
Diagnostic arthroscopy
in select cases) for direct visual inspection and probing of the cartilag
LKC Imaging Console v1.0
Status: pending clinical review
Imaging Visual
Cartilage Injury Imaging
Medical illustration pending clinical review
Target Size: 800 × 600px•pending clinical review•pending
Cartilage Injury Imaging visual pending clinical review.Treatment options
We offer structured, staged treatment pathways, focusing on conservative and non-surgical approaches. Suitability depends on individual assessment.
A
Physiotherapy to optimize joint loading and muscle support
Indicated where clinically appropriate.
Explore Treatment >B
Hyaluronic acid or PRP joint injections to reduce friction
Indicated where clinically appropriate.
Explore Treatment >C
Activity modification and weight management to reduce impact
Indicated where clinically appropriate.
Explore Treatment >D
Surgical joint preservation procedures for symptomatic focal defects
Indicated where clinically appropriate.
Explore Treatment >Staged Clinical Pathway
Clinical Treatment Staged Pathway
Patient Education Pathway: This pathway diagram is for patient educational purposes only. It is not a diagnostic, triage, or clinical decision-making tool. Individual care options are determined dynamically following consultation.
When might surgery be considered?
Surgical intervention may be discussed when non-operative treatments do not provide sufficient relief, symptoms significantly restrict daily function or quality of life, and clinical and imaging findings correlate.
Microfracture to stimulate fibrocartilage healing
Consultant orthopaedic procedure.
Autologous Chondrocyte Implantation
ACI) or cartilage transfe
Choosing the right treatment
Decisions depend on a detailed diagnosis, symptom severity, patient goals, activity expectations, and general health history. We support shared decision-making, ensuring you fully understand the expected benefits, risks, and alternatives of each pathway.
Frequently Asked Questions
A cartilage defect is a focal, localized area of damage. Arthritis is widespread cartilage wear across the entire joint surface.
Due to a lack of blood supply, cartilage has very limited self-repair capacity, often requiring intervention to prevent progression.
A keyhole procedure that creates tiny holes in the bone to release stem cells, forming a scar-like cartilage repair.
Yes, lubricating or anti-inflammatory injections can manage pain and support rehabilitation.
When focal cartilage damage causes persistent mechanical symptoms or pain that limits rehab.
Highly recommended for insurance validation; self-paying patients can contact us directly.
Clinically Reviewed
Mr Ricardo J Pacheco (GMC 4145976)Consultant Trauma & Orthopaedic Surgeon
Last reviewed: 29 July 2026
- NICE guidance TA477 — Autologous chondrocyte implantation for treating symptomatic articular cartilage defects of the knee
- NICE guideline NG226 — Osteoarthritis in over 16s: diagnosis and management
- Cartilage Injuries in the Adult Knee: Evaluation and Management - PMC (pmc.ncbi.nlm.nih.gov)
- Diagnosis of knee cartilage injuries—an international Delphi ... (cartilagejournal.org)
- Cartilage damage (sportsortho.co.uk)
- Knee Cartilage Lesions - Overview (sportsmedicine.mayoclinic.org)
- Cartilage damage: Symptoms, causes, diagnosis, and ... (medicalnewstoday.com)
Would you like an individual knee assessment?
A consultation can help clarify the cause of your symptoms and discuss appropriate treatment options.
Face-to-face appointments are arranged through the reception team at the chosen clinic. Video consultations use Google Calendar where available.
Continue Your Knee Journey
Explore Treatments→Next Step: Explore Treatment Options
Treatment pathways range from physiotherapy and bracing to injections or surgical procedures, tailored to your symptoms, diagnosis, and physical goals.
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Medical Disclaimer
This website provides educational and general information about knee symptoms, conditions, and treatments. The content is for informational purposes only and does not constitute medical advice, diagnosis, or a treatment plan. It should not be used as a substitute for a professional consultation, examination, or clinical decision-making by a qualified orthopaedic specialist.
If you are experiencing symptoms or are concerned about a knee problem, please arrange a clinical consultation. If you have urgent symptoms, severe pain, or are unable to put weight on your leg, please read our urgent advice guidance or contact emergency services immediately (dial 999 or NHS 111).