Bruskskade

Bruskskade is a term used in orthopedics to describe damage to articular cartilage within a joint. The injury can affect only the cartilage (chondral lesion) or extend into the subchondral bone (osteochondral lesion). Articular cartilage provides a smooth, low-friction surface for joint movement, but it is avascular and lacks nerves, which limits its capacity to heal after injury.

Commonly affected joints include the knee, ankle, hip, and smaller finger joints. Causes include acute trauma from sports or falls, repetitive microtrauma, and degenerative conditions such as osteoarthritis. Symptoms often include joint pain, swelling, stiffness, and sometimes catching, locking, or a reduced range of motion.

Diagnosis relies on clinical examination and imaging. MRI is the most informative modality for assessing cartilage defects, while X-rays may reveal secondary joint changes. CT arthrography can be useful in complex cases, and arthroscopy may serve both diagnostic and therapeutic roles.

Lesions are commonly classified by depth and extent using systems such as the Outerbridge classification (grades I–IV) or the International Cartilage Repair Society (ICRS) system. This helps guide treatment decisions.

Treatment depends on lesion size, depth, patient age, and activity level. Nonoperative management includes activity modification, physical therapy, NSAIDs, bracing, and possibly intra-articular injections. Surgical options for cartilage restoration include marrow-stimulation techniques such as microfracture, drilling, and newer approaches like autologous chondrocyte implantation (ACI/MACI) or osteochondral autograft/allograft transplantation. Debridement or fixation of unstable fragments may also be indicated.

Prognosis varies with defect characteristics and treatment. Smaller, contained lesions in younger patients tend to fare better, whereas larger defects carry a higher risk of persistent symptoms and progression to osteoarthritis. Prevention focuses on injury prevention, proper conditioning, and addressing joint malalignment or instability.