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What is Articular cartilage/where is it?

There are two types of cartilage in the knee. Articular Cartilage and Meniscal Cartilage. In this section, we are referring to Articular Cartilage. Please see the section on meniscal injury, or degenerative meniscus for information on those subjects.

The Knee Joint

Articular cartilage is the shiny white covering at the bone ends within all joints and is referred to as Chondral or Articular Cartilage. This is a hard-wearing, smooth surface that allows the joint surfaces to move uninterrupted over one another. It is kept healthy by the contact or loading of one joint surface on another and a small amount of fluid in the knee known as synovial fluid.

This type of cartilage is prone to wear and there are many reasons this may happen. These include:

• Being overweight
• Abnormal angles at the joint
• Injury or previous injury
• Other related joint disease
• Genetic factors
• Age

Wear and tear

This is often used to describe this commonly presenting problem. Other terms that you may hear are Osteoarthritis and ‘Degeneration’. The terms are nearly always talking about the same thing.

What ages does this affect?

Anybody can suffer with these problems. From the age of 40 this becomes much more common.

What does it feel like?

Many patients report that the knee aches a lot, particularly the longer they walk, but often the pain is noticed as much when at rest.
The joint might swell from time to time, further adding to the discomfort. It also may ‘stick’ or ‘lock’ at a certain point in the movement. You may also experience a buckling of the knee and feel that to walk with stick will help with confidence.

How long does the pain last?

Often enough, the pain is something that will not disappear altogether. The pain may worsen in response to a bit too much activity or for no apparent reason at all – which can be very frustrating. The pain may also decrease for long periods of time.  When the pain worsens it is not unusual for it to last anything from 2 weeks to 3 or 4 months

Is it harmful?

No, despite the pain, if you can move the joint and remain as active as possible the knee will benefit.
What can I do about it?

• Lose weight - diet, much more than exercise, is the key to this.
• Keep the joint mobile – do as much is your knee will allow you.
• Take pain relief – your pharmacist and/or GP can advise you on the best medicines to take.

What happens if I’ve tried all of these things and I’m no better?

• The next step is to consult your own doctor. He may be able to advise on better painkillers than you have been taking.
• Your GP may send you for an x-ray.

Depending on how long the pain lasts and the appearance of your x-ray your GP may ask if you’d like to see a specialist about your knee. This may be :

• A Physiotherapist. To advise about exercise and taking care of your knee.
• A specialist Physiotherapist who is specifically trained to assess whether further investigations or surgery is appropriate for you.
• An Orthopaedic consultant .