A chondral defect is a crater in the articular cartilage.

osteochondral defect
A chondral defect implies that only the cartilage is damaged, while an 'osteochondral defect' implies that the underlying bone is also damaged.

 

What is the cause of a chondral defect?

A chondral defect may be caused by a metabolic or genetic disorder, poor blood supply or a sharp injury.

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Traumatic focal defect

Where the rest of the cartilage is healthy the isolated crater can be assumed to have been caused by an injury, where the joint surface and a bit of underlying bone has been knocked off. The person lands with force onto the bent knee, or there is a direct blow to the knee, knocking off a piece of articular cartilage.The chondral defect is the crater. The loose body is the bit that breaks off.

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How are chondral defects of the knee managed?

Smaller defects may be managed with arthroscopic debridement, to flatten down the sharp edges and prevent further damage. A radiofrequency wand can also be used for the same purpose.

A small awl may be used to poke through to the underlying bone to allow bleeding and migration of stem cells into the defect (microfracture).

If the crater is large, and the cartilage around it healthy, then the surgeon may try to 'patch' the hole with healthy cartilage, such as in the procedure of mosaicplasty.

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Peer-reviewed papers

  • Quote:

    "...treatment of chondral knee injuries remains a challenge for the orthopedic surgeon, mainly owing to the characteristics of the cartilage tissue, which promote low potential for regeneration....Surgery should be reserved for patients with detached chondral fragments, blocked range of motion, or the failure of non-operative treatment."

    Citation: da Cunha Cavalcanti FM, Doca D, Cohen M, Ferretti M. UPDATING ON DIAGNOSIS AND TREATMENT OF CHONDRAL LESION OF THE KNEE. Rev Bras Ortop. 2015 Nov 16;47(1):12-20. doi: 10.1016/S2255-4971(15)30339-6. PMID: 27027078; PMCID: PMC4799341.

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Dr Sheila Strover (Editor)
BSc (Hons), MB BCh, MBA

See biography...

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