Figure 1: Chondral defect of medial femoral condyle

Figure 1 shows the damage to the medial femoral condyle. This is the one I felt most when planting and turning. Chondral (cartilage) defects are graded 1-4, with 1 being minimal damage and 4 being 50 to 100% loss. This defect was a 4, and you can see the exposed bone in the middle.

 Figure 2: Chondral defect in trochlea

Figure two is more damage. This defect is in the trochlea – the groove on the femur for the articulation of the patella. In the shot on the left,one of the surgical tools is pulling on the tissue.  Again, this was a grade 4 defect. 

Figure 3: Unstable (loose) cartilage in knee joint 


Figure 4: Healthy cartilage

Figure 5: A plica (fold of the joint lining) that had become irritated and was also removed

Figure 6: Microfractures applied to bone in chondral defect 

This shot is of the microfractures in one of the defects. Note the holes that have been punched into the bone. These should secrete new tissue (marrow-rich blood) to fill in the damage. If rehabbed well, the signal to the tissue will be to form cartilage.  The new cartilage is not the same as the original hyaline cartilage, but a hybrid between hyaline and fibrocartilage.