Broskskador

Broskskador, or cartilage injuries, are damage to the articular cartilage of a joint and, if deeper, to the underlying subchondral bone. They mainly involve hyaline cartilage on weight-bearing surfaces and are categorized as chondral (cartilage-only) or osteochondral (cartilage with bone). The knee is most commonly affected, followed by the ankle and hip. Causes include acute trauma (sports injuries), repetitive overuse, joint instability, malalignment, and degenerative conditions such as osteoarthritis or osteochondritis dissecans.

Symptoms include joint pain that worsens with activity, swelling, stiffness, reduced range of motion, and sometimes catching or locking if a fragment is loose. Diagnosis combines clinical evaluation with imaging; X-ray can show bone involvement, but MRI best assesses cartilage loss, while CT provides detailed bone information. In some cases diagnostic arthroscopy is used.

Classification systems include Outerbridge and ICRS grades, ranging from superficial fissures to full-thickness loss. Prognosis depends on lesion size, depth, location, age, and activity level; smaller defects generally have better outcomes.

Treatment is tailored to the defect. Nonoperative approaches include activity modification, physical therapy, bracing, and injections (hyaluronic acid or corticosteroids). Surgical options for suitable defects include microfracture, drilling or abrasion, autologous chondrocyte implantation, autologous osteochondral transfer (mosaicplasty), and osteochondral allograft, as well as focal resurfacing or fragment fixation in selected cases. Rehabilitation is procedure-specific.

Prevention focuses on injury prevention, joint stabilization, and correcting malalignment or instability to reduce cartilage damage risk.