Focal chondral (joint surface cartilage) damage

What is focal chondral damage?

This refers to a specific area of damage to joint surface (the tough, rubbery cartilage that covers the ends of the bones). This cartilage acts as a shock absorber, as well as allowing the bones to move smoothly over one another.

How is it caused?

  • Chondral damage can be caused by an injury such as a twist, fall or a direct blow to the knee.
  • Chondral damage caused by an injury often accompanies damage to a ligament, for example an anterior cruciate ligament tear
  • In children and young adults, sometimes a piece of the joint surface cartilage spontaneously breaks away with a piece of bone in a condition called osteochondritis dissecans
  • Chondral damage can be the first stage in osteoarthritis

What are the symptoms?

  • Symptoms can include pain and swelling. However, as there are no nerves in the joint surface cartilage, some people do not have any symptoms at first
  • If a loose fragment breaks away, it can lead to ‘mechanical locking’, which can painfully restrict movement

How is it diagnosed?

A diagnosis made during a medical consultation can be backed up with X-rays, and a CT or MRI scan to show the extent of the damage. You may also be offered a knee arthroscopy, which allows the specialist to examine the joint and treat it at the same time.

How is it treated?

Joint surface cartilage has very limited ability to repair itself. Sometimes the area of damage is small enough so that in time the condition settles and causes few, if any, symptoms. Unfortunately this is not always the case and you may need to have surgery. There are many surgical options, including arthroscopy and trimming the loose fragments of the joint surface. Other options are resurfacing treatments, such as microfracture, mosaicplasty/osteochondral plugging, or autologous chondrocyte implantation, or focal replacement with metallic implants (hemicap).

Important: This information is only a guideline to help you understand your treatment and what to expect. Everyone is different and your rehabilitation may be quicker or slower than other people’s. Please contact us for advice if you’re worried about any aspect of your health or recovery.


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