Understanding Knees Part 3: Articular Cartilage Injury (final instalment)

The closing instalment of the knee injuries series covers articular cartilage, the smooth lining at the ends of the femur and tibia that reduces friction and disperses load. Dr Claire Minshull explains that in young footballers damage usually follows a single big trauma, often alongside ACL or meniscal injury, chipping a defect into the surface; repeated smaller injuries from an unstable knee can do the same. Symptoms include a dull ache that worsens after exercise, swelling, giving way and locking. Because cartilage has no blood supply it does not repair, so surgery is usually needed eventually, from smoothing the defect edges to microfracture or autologous chondrocyte implantation. She stresses that strength, balance and reaction-time work is the only real prevention.