Chrondral fracture

When the cartilage coating the bone is broken. Cartilage has no bloody supply, so cannot repair itself. If the cartilage is damaged, pieces can break off and cause pinching or impingement in the ankle.

What is it?

The hard, slippery articular cartilage that coats the bones in all joints can be damaged as a result of injury. As with a bone fracture, chondral fracture is usually either caused by a direct impact, or by a sudden twisting of the ankle. The twisting can force the bones of the ankle to impact on one another, fracturing the thin layer of cartilage.

Cartilage has no bloody supply, so cannot repair itself. If the cartilage is damaged, pieces might break off and cause pinching or impingement in the ankle. As the joints are dependent on articular cartilage for smooth movement, cartilage damage will also impair movement.

How does it feel?

Pain will occur with movement and possibly when you put weight on the ankle joint. There is likely to be inflammation and swelling during or after exercise. You may also experience a clicking or catching sensation on movement. If pieces of cartilage have broken off, you may also feel a sensation of instability.

Diagnosis

An x-ray will be used to rule out a fracture of the bone. An MRI scan will show the extent of cartilage damage and show up any loose bodies that may be pinching the soft tissue of the joint.

Surgery

Using arthroscopy, the surgeon will remove any loose pieces of cartilage. Around the fracture, the surface of the cartilage will be smoothed out. If the cartilage has been broken away to expose the bone, the surface of the bone can be cut, scraped, burred or lasered to stimulate the growth of a new surface called fibrocartilage. This is not as smooth and shiny as articular cartilage, but is still effective.

Recovery

The recovery period is variable depending upon the size, position and severity of the chondral fracture. However, most heal up over a six-week period.

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