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Knee Cartilage Tear

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Knee Cartilage Tear

Knee Cartilage Tear

Introduction

Normal function of the knee in both the athletic and the nonathletic population depends on the integrity of the many components that make up this complex joint. Structures made of cartilage in particular play a key role in maintaining normal function. Within the knee, there are two different types of cartilage: (1) articular (hyaline) cartilage, which is the thin layer of smooth, white, shiny tissue covering the articulating bones surfaces, and (2) the meniscal cartilages, which are two crescent-shaped wedges of elastic cartilage that lie between these surfaces. However, the focus of this paper is on the knee cartilage injury.

Mechanism of Knee Cartilage Injury

Injury to articular cartilage in the knee can vary from small patches of softening or fraying to unstable or loose flaps or even patches of bare bone, where the cartilage has worn away altogether. This can occur through a variety of different mechanisms, including blunt direct or indirect trauma causing anything from minor “bruising” of the cartilage to major damage such as detachment of a fragment of bone and the overlying cartilagean osteochondral injury (Miller, 2008). The cartilage may also be damaged by chronic conditions such as osteoarthritis. Disruption of articular cartilage structure and function can result in various symptoms including pain and joint swelling. The joint may click and feel unstable or “give way.” Where there is more extensive damage, the knee may become increasingly stiff.

The Sports Engaging Knee Cartilage Tear

The gymnast, when performing tumbling exercises on the floor, quickly accelerates with a rebounding movement, twisting, changing direction, and finishing, using a combination of acrobatic skills, with a sudden declarative stop at the end of a tumbling sequence. Tumbling surfaces are made of spring flooring to improve the gymnast's ability to increase vertical height, from which advanced skills, such as multiple somersaults, with or without twisting elements, are completed. The types of injuries can be better understood by considering these factors and by considering the increasing difficulty of skills performed by the elite gymnast (Miller, 2008).

Disorders of the kneecap that irritate the cartilage covering on its underside can also lead to disabling symptoms, making it difficult to run or land while executing gymnastic skills. An example of this would be when the patella is not moving along a symmetrical path or is not stable when moving. Both MRI and X-ray studies accurately diagnose these disorders of the knee joint. The majority of these injuries of the knee joint and patella benefit from arthroscopic surgery (American Academy of Orthopaedic Surgeons, 2012).

History and Occurrence of the Injury

Articular cartilage has the lowest coefficient of friction of any known substance, which in conjunction with the additional lubrication provided by synovial joint fluid allows the articulating surfaces of the knee joint to slide freely against each other. In the healthy joint, articular cartilage is only a few millimeters thick, increasing in depth where the loads are greatest (see photo at top of column).

Articular cartilage is made up of cellular and structural ...
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