Diagnosis and management of chondral delamination injuries of the knee

Abstract

Background: Chondral delamination with intact articular surface is an under-recognised entity with no previous reports on how it should be managed. The purpose of this article is to increase awareness of this entity and make recommendations for its management.

Methods: We present a small case series of three patients who presented with knee pain and subsequent MRI scans revealed chondral delamination with intact articular surface as the only explanation of symptoms.

Results: Two of the lesions were located in the patella and one on the lateral aspect of the medial femoral condyle. All three were treated with bioabsorbable pin fixation. The delaminated area was easily recognised at arthroscopy by its bogginess on probing. All three patients made an excellent recovery and the lesions healed on MRI.

Conclusion: Chondral delamination with intact articular surface is best managed with bioabsorbable pin fixation so that it can be salvaged in order to optimise patient outcomes and avoid deterioration to a full thickness chondral lesion once the articular surface has separated.

Keywords: Cartilage delamination; Cartilage fixation; Chondral darts; Chondral delamination; Chondral pins; Intact articular surface.