Chondral delamination of the knee and its management: a case report and review article

• Published in: BMC surgery Vol. 22; no. 1; pp. 1 - 325
• Main Authors: Mansour, Marah, Abboud, Yazan, Alhaffar, Mhd Alaa Aldin, Souliman, Ola, Haffar, Massa, Mustafa, Younes, Alsuliman, Tamim, Samaan, Michel
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 29-08-2022; BioMed Central; BMC
• Subjects: Arthritis; Arthroscopy; Bone healing; Bone surgery; Calcification; Cartilage; Cartilage (articular); Case Report; Chondral delamination; Collagen; Degenerative arthritis; Delamination; Injuries; Knee; Knee lesions; Laminated materials; Locking; Magnetic resonance imaging; Microfracture; Orthopedics; Osteoarthritis; Pain; Patient satisfaction; Postoperative period; Range of motion; Resonance; Subchondral bone; Trauma
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-022-01775-w

Abstract
Chondral delamination is the separation or debonding of the articular cartilage from the underlying subchondral bone. The hyaline cartilage has a limited capacity for healing, meaning it does not possess the innate ability to restore its normal structure or to heal the subchondral bone once detached from it. The purpose of this article is to report the outcomes of a microfracture technique used to manage chondral delamination in a 59-year-old male; we also reviewed the treatment options mentioned in the literature. The patient was admitted to the Department of Orthopedic Surgery complaining of recurrent severe right knee pain with multiple episodes of knee locking, denying any direct or twisting trauma to the knee. The plain X-ray showed mild degenerative changes with articular surface irregularity. On Magnetic resonance imaging, wide chondral delamination was noted in the medial femoral condyle. After 12 months’ post-op, his condition improved. No locking was observed. Pain improved in comparison to the pre-operative levels. The international knee documentation committee improved from 26.4% to 52.9%. In a follow-up magnetic resonance imaging, the adhesion of most parts of the delaminated cartilage.