Cartilage Injuries

Cartilage is a smooth, protective tissue that covers the ends of bones inside a joint. It helps joints move freely and absorbs impact during walking, running and sport. A cartilage injury occurs when this surface is damaged, which can lead to pain, swelling, reduced movement and mechanical symptoms such as catching or locking.

Cartilage injuries commonly affect the knee, but can also occur in the ankle, hip, shoulder and elbow. Some injuries happen suddenly after trauma, while others develop gradually through wear and tear.

At the Royal Buckinghamshire Hospital, we provide consultant-led assessment to confirm the cause of symptoms and recommend the most appropriate treatment plan.

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Types of Cartilage Injury

Cartilage injuries may be described by where and how the damage occurs:

• Focal (localised) cartilage defect
  A specific damaged area of cartilage, often after an injury.
• Chondral or osteochondral injury
  Damage to cartilage alone (chondral) or cartilage plus the underlying bone (osteochondral).
• Loose bodies
  A small fragment of cartilage (sometimes with bone) can break off and move within the joint, causing locking or catching.
• Degenerative cartilage wear
  Gradual cartilage thinning and breakdown over time, often associated with osteoarthritis.
• Cartilage injuries linked to other joint damage
  Cartilage damage can occur alongside ligament injuries or meniscus tears (particularly in the knee).

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Common Causes of Cartilage Injuries

Cartilage can be damaged by:

• Twisting injuries or awkward landings (common in sport)
• Direct impact or trauma to a joint
• Dislocation (e.g., kneecap dislocation can injure cartilage)
• Repetitive overload over time
• Poor joint alignment or instability increasing uneven joint stress
• Previous joint injury increasing the risk of longer-term cartilage problems
• Degenerative change (wear and tear) with age

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Symptoms of Cartilage Injuries

Symptoms vary depending on the joint and severity, but commonly include:

• Joint pain, often worse with activity or weight-bearing
• Swelling (may be recurrent, especially after exercise)
• Catching, clicking or grinding sensations
• Locking (the joint gets stuck) or giving way
• Reduced range of movement or stiffness
• Pain when squatting, twisting, climbing stairs, or running (knee)
• A feeling that the joint is unstable or not moving smoothly

If the joint is locked, very swollen, or you cannot weight-bear after injury, assessment is recommended promptly.

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Diagnosis at Royal Buckinghamshire Hospital

Your consultant will assess the joint and identify the most likely cause of symptoms. Diagnosis may include:

• Review of your injury history, symptoms and activity demands
• Physical examination of the joint, including stability, swelling and movement
• Imaging where appropriate, such as:
  • X-ray to assess bone and joint space, and rule out fractures
  • MRI scan to assess cartilage, meniscus/ligaments (knee), and other soft tissue structures
  • CT scan in selected cases (especially for osteochondral injuries or loose bodies)

In some cases, cartilage injuries are confirmed during arthroscopy (keyhole surgery), which can also allow treatment at the same time.

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Treatment & Management

Treatment depends on the joint affected, size and location of the injury, your age, activity level and symptoms.

Non-surgical management

Many patients benefit from conservative treatment first, including:

• Activity modification to reduce joint overload
• Physiotherapy to strengthen supporting muscles and improve joint control
• Weight management where relevant to reduce load on weight-bearing joints
• Pain relief and anti-inflammatory medication where appropriate
• Bracing or orthotics in selected cases (particularly for alignment and stability)
• Injection treatments may be discussed in some circumstances to manage symptoms

Surgical treatment (when needed)

Surgery may be considered if symptoms persist, the joint locks, or there is a significant defect. Options vary depending on the injury and joint, and may include:

• Arthroscopy to remove loose bodies or smooth damaged cartilage edges
• Repair or restoration procedures for selected cartilage defects
• Procedures to improve joint alignment or stability when these contribute to cartilage stress
• In advanced degenerative cases, discussion of arthritis management options

Your consultant will explain the most appropriate approach and the expected recovery and rehabilitation plan.

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Recovery and rehabilitation

Cartilage recovery is highly dependent on the injury type and treatment. Physiotherapy is often essential to:

• Restore range of motion
• Improve strength and joint stability
• Reduce swelling and improve function
• Support a safe return to work and sport

If you have surgery, your rehabilitation plan may include temporary restrictions on weight-bearing and a structured progression back to activity.

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When to seek urgent help

Seek urgent medical advice if you experience:

• A locked joint that will not straighten
• Severe swelling soon after injury
• Inability to weight-bear
• Significant deformity after trauma
• Increasing redness, heat, fever, or feeling unwell (possible infection)

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If you have joint pain with swelling, catching, or locking — especially after an injury — contact Royal Buckinghamshire Hospital for assessment and treatment planning. There is no need to be registered with the hospital, or live locally.

If you have insurance which covers consultations, we can in most cases invoice the insurer directly. Where you are paying directly, any costs will always be discussed.