When should cartilage soreness be checked?

Which warning signs can't wait?

Get medical help now for fever with a red, hot joint. Don't wait after an injury that changes the joint's shape or stops you standing on it. New weakness, numbness or calf swelling after a joint procedure also needs quick help.

A locked joint isn't normal soreness. Use urgent care if you can't straighten it, swelling grows fast or you feel very ill. A routine clinic visit isn't enough for those warning signs.

Sudden, severe changes can't wait.

What will happen during the exam?

Expect questions about the sore spot and what starts the ache. They'll check swelling, strength, movement and whether the joint feels steady. An old X-ray or MRI may help when it shows the same area.

You'll also talk about time and effort. You may need several visits. An operation may bring months of limits and rehab, so recovery must work with your home life.

A good exam may end with no procedure.

What if the usual care hasn't settled it?

Get another exam before spending more money. Say what you want to change, such as sleep, walking or swelling after activity. Ask when to compare those same things after care.

QC Kinetix uses orthobiologics as a medical name for non-surgical care that uses something from your body. One option is PRP, short for platelet-rich plasma. Staff draw your blood, separate it and concentrate one portion for the sore area.

The medical provider is the staff member who checks your joint and discusses regenerative treatments. Ask if that person is a doctor. No one can promise cartilage repair.

A fair answer may be yes, no or not yet.

Sources

1. In a meta-analysis of 63 studies covering 5,397 knees of 4,751 adults with NO symptoms and no injury, the pooled prevalence of cartilage defects on MRI was 24% (95% CI 15% to 34%), rising from 11% in adults under 40 to 43% in adults aged 40 and over. Meniscal tears were present in 10%, bone marrow lesions in 18% and osteophytes in 25%.

   Culvenor AG, et al. — Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis.. Br J Sports Med, 2019. DOI: 10.1136/bjsports-2018-099257.

2. A review of 31,516 knee arthroscopies documented 53,569 hyaline cartilage lesions in 19,827 patients. Grade III lesions of the patella were the most common and grade IV lesions were predominantly on the medial femoral condyle. Patients under 40 with a grade IV lesion made up 5% of all arthroscopies, 74% of them with a single chondral lesion.

   Curl WW, et al. — Cartilage injuries: a review of 31,516 knee arthroscopies.. Arthroscopy, 1997. DOI: 10.1016/s0749-8063(97)90124-9.

3. In 25,124 knee arthroscopies performed over 15 years, chondral lesions were found in 60% of patients. Of the documented lesions, 67% were localized focal chondral or osteochondral lesions, 29% were osteoarthritis and 2% osteochondritis dissecans. Patients with one to three localized grade III-IV lesions under age 40 - the classic cartilage repair candidate - were 7% of all patients, rising to 9% under age 50.

   Widuchowski W, et al. — Articular cartilage defects: study of 25,124 knee arthroscopies.. Knee, 2007. DOI: 10.1016/j.knee.2007.02.001.

4. A JBJS evidence-based review of chondral lesions of the knee sets management by lesion size, location, limb alignment and rotation, and patient demand rather than by product: osteochondral autograft transfer is described as durable and predictable for smaller lesions (under 2 cm2) in young active patients, while lesions of 2 cm2 or more are typically treated with osteochondral allograft transplantation, particulated juvenile articular cartilage, or matrix-associated chondrocyte implantation, with favourable mid- and long-term results reported for allograft or MACI in large lesions of 3 cm2 or more.

   Dekker TJ, et al. — Chondral Lesions of the Knee: An Evidence-Based Approach.. J Bone Joint Surg Am, 2021. DOI: 10.2106/JBJS.20.01161.

5. In a 19-year multicentre Norwegian follow-up of 322 patients (328 knees) with an arthroscopically verified focal cartilage lesion, mean age 36.8 at index surgery, those who had not needed arthroplasty or osteotomy reported significantly better pain, Lysholm and KOOS scores at final follow-up than before their index operation. By follow-up 17.7% had undergone later cartilage surgery, and nearly 50% met the study's treatment-failure definition, with BMI of 25 or more among the main risk factors.

   Birkenes T, et al. — Long-Term Outcomes of Arthroscopically Verified Focal Cartilage Lesions in the Knee: A 19-Year Multicenter Follow-up with Patient-Reported Outcomes.. J Bone Joint Surg Am, 2024. DOI: 10.2106/JBJS.23.00568.