Most knee cartilage replacement surgeries are called OATs surgerieseither osteochondral autograft transplantation or osteochondral allograft transplantation surgeries. It is possible to treat minor tears naturally as well as through physical therapy. It is critical to diagnose and treat a torn cartilage tear based on its extent and location. Effect of a physiotherapy rehabilitation program on knee osteoarthritis in patients with different pain intensities. What are the symptoms of a torn meniscus? Research suggests it is more effective and lasts longer than hyaluronic acid injections. Anunloader knee bracestabilizes the knee to limit side-to-side movement while allowing the knee to bend and extend without limitation. Apley test (grinding) test: The patient lies prone, with their knee flexed to 90 degrees and their hip extended. To learn more about the possibility of receiving some private treatments to help aid your recovery contact us as soon as possible. Tears are noted by how they look, as well as where the tear occurs in the meniscus. A grade 2 (moderate) MCL tear generally takes four to six weeks to heal with treatment. Depending on the individual patients circumstances, some symptoms and answers to the question can you still walk with a torn meniscus? may be different. 2005-2023 Healthline Media a Red Ventures Company. A torn cartilage condition is characterized by the tearing of the articular cartilage. The ACL is next to the menisci, running through the center of each knee joint. nws8zemwgist. the entire playoffs. What To Do When You Have No Cartilage in Your Knee. Should I have a brace for a torn knee? This produces concentrated blood platelets that are injected into the joint in two or three places. Search All ICD-10 Toggle Dropdown. If your tear is severe, you may need surgery to stabilize your knee and repair it. Consider how it can be useful in the same way that a road repair analogy can be useful. Meniscus cartilage is a tough but flexible tissue that acts as a cushion between the ends of bones in a joint. As part of the discussion of your treatment options for a knee cartilage injury, your doctor may recommend trying an injection in your joint. He is the founder and main author of brandonorthopedics.com, a website that offers valuable resources, tips, and advice for patients looking to learn more about orthopedic treatments and physiotherapy. Microfracture surgery is an articular cartilage repair surgical technique that works by creating tiny fractures in the underlying bone.This causes new cartilage to develop from a so-called super-clot. Viscosupplementation, sometimes called gel injections, refers to the use of injecting hyaluronic acid into the knee to decrease pain and improve joint movement. The surgeon removes a small (<1cm . How Long Should You Wait To Go Bowling After Knee Surgery? Combination intra-articular injections can also be effective for people with no knee cartilage. The medial meniscus is a crescent-shaped, cartilaginous band found between the medial tibia and medial femur. Pain and swelling are the most common signs of knee injury. Ordinary painkillers, such as paracetamol or ibuprofen, should be taken if your joints are painful. This "loose body" can move about in the joint, and it may occasionally . American Academy of Orthopedic Surgeons. In addition moving around with a torn meniscus could pull fragments of the cartilage into the joint causing larger knee issues which could . The kneecap will be moved aside to expose the ends of the femur, the upper leg bone, and tibia, the lower leg bone. However, because an autograft involves the removal of healthy material from elsewhere in the body, it is a more invasive surgical procedure. You might need physical therapy to fully recover from surgery if you have a knee injury. After a mild tear, rest and self-care are the best ways to treat the injury. Many UK citizens dont know that they could be eligible to receive free physiotherapy treatments after suffering this sort of injury. Kristen Gasnick, PT, DPT, is a medical writer and a physical therapist at Holy Name Medical Center in New Jersey. Strengthening the muscles around the knees and hips helps offload the knee joint and support your body weight so that less pressure is applied to the joint surfaces and surrounding cartilage. The time it takes to fully recover from an MCL tear depends on how severe the tear is. The procedure begins with an incision from above the knee down past the knee joint. Injuries. As a result of damage to subchondral bone from cartilage loss, further damage can occur to the remaining cartilage from lack of cushioning in the knee, causing lesions or tears in the remaining cartilage. Meniscus surgery is a common operation to remove or repair a torn meniscus, a piece of cartilage in the knee. Do not do these exercises if you are experiencing a flare-up of pain. The lateral meniscus is on the outside of the knee. It works well for repairing isolated cartilage damage caused by arthritis, but it can also be used to repair diffusely damaged cartilage. To speak with a MACI Mentor, call 1-888-237-5493 or visit MACImentors.com. We avoid using tertiary references. Kristen Gasnick, PT, DPT, is a medical writer and a physical therapist at Holy Name Medical Center in New Jersey. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. A study in the World Journal of Orthopedics notes that rehabilitation after any cartilage resurfacing procedure is necessary for success. Then a replacement core, made of bone and cartilage from another part of the body or a donor knee, is used to fill in the hole. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Cartilage does not regrow or replace itself, but it can be repaired or replaced depending on how it is damaged. A third option is called autologous chondrocyte implantation. Recovery Time For Torn Cartilage In Knee Guide. The cells do not receive as much blood as in the higher air pressure region. Cartilagea type of connective tissue that lines the end of bonesprovides cushioning for joints and prevents bones from rubbing together. By participating in physical therapy following the operation, most people can resume normal, everyday activities within 6 weeks, though a full recovery can take several months. Repeated or prolonged squatting can also tear the meniscus. It starts with an arthroscopic cartilage biopsy of the knee. A patch that heals over time may be used to achieve this goal, either through surgery or through the use of a surgical procedure. Because of the three zones, it is impossible to heal on its own for tears in the knee. When there is a rupture of the knee, such as an ACL or PCL tear, it is frequently confused with a cartilage tear. He is the director of adult spinal deformity & complex spinal reconstruction at Massachusetts General Hospital and is on the faculty at Harvard Medical School. A common knee injury, the tear of the cartilage in the knee, can cause pain, swelling, and a sensation of locking in the affected knee. After the procedure, youll need to keep weight off your knee for about 6 weeks and use a continuous passive motion (CPM) machine several hours a day to bend and straighten the knee. (Right) Flap tear. In this article, we review traditional and newly emerging approaches to knee cartilage replacement and repair. Symptoms of a meniscus tear include pain, swelling, and stiffness. Hyaluronic acid used for injections is derived from the combs of chickens. The meniscus in the knee is usually damaged by a twist occurring on a slightly flexed knee. Hall M, et al. The procedure can reduce pain, improve mobility and stability, and get you back to life's activities. The knee meniscus is a special layer of cartilage that lines the knee joint. The cartilage is found between the bones in the knee joint and protects them when you move. Treatments include rest, ice, elevation, pain relievers, physical therapy, and surgery. Request an appointment using our secure online form. These growth factors ease pain by reducing the effect of inflammation at the cellular level. During knee arthroscopy, a surgeon uses an arthroscopea tool about the width of a pencil with a camera and light attachedto view the inside of your knee joint. Healthline Media does not provide medical advice, diagnosis, or treatment. Without adequate cartilage, the bones of the knee become irritated and inflamed due to increased pressure and friction with movement and weight-bearing of the leg. If you experience pain while doing exercise, stop. A 2018 study found that physical therapy helped reduce pain, not just in cases of mild knee osteoarthritis, but in people dealing with moderate pain, too. . The injectable is a non-degradable substance, meaning the body does not break it down. There is no one-size-fits-all answer to the question of torn cartilage treatment, as the best course of action will vary depending on the specific case. When the new cartilage is ready to be implanted, the surgeon shapes it to fit the portion of natural cartilage that needs to be replaced. The cartilage can be torn in a variety of ways, including through overuse, sudden impact, or twisting. The damaged bone grows back thicker than before as the body tries to repair the damage, similar to thickened scar tissue that develops after an injury. Cartilage can become damaged due to a trauma such as a pivoting sport or when turning the knee or bending it deeply. Treatment for a torn meniscus often begins conservatively, depending on the type, size and location of your tear. Special centers, such as Yale University, are using robotic surgery to improve component positioning, biomechanics, and quality of movement for knee replacement surgeries. Subchondral bone is the type of bone directly under the cartilage at the ends of bones. 2020 Nov 15;28(22):914-922. doi: 10.5435/JAAOS-D-20-00266. Physical therapy is useful to regain full function of the knee, which occurs on average 4-5 months after surgery. It can be torn traumatically through a twist on the knee when it is flexed, and it is a common sports injury. Most injuries result in at least some degree of swelling and pain in the joint. Knees contain two types of cartilage: articular and meniscus. Dickson BM, Roelofs AJ, Rochford JJ, Wilson HM, De Bari C. The burden of metabolic syndrome on osteoarthritic joints. Osteochondral autograft. 7 With minimal resection during arthroscopy . 20% 3 star 13% 2 star 10% 1 star 22% How customer reviews and ratings work View Image Gallery Amazon Customer. Over time, hyaluronic acid levels in the joints decrease, especially as the joints wear down with osteoarthritis. Broken Hip In The Elderly Mortality Rates, A Fractured Ankle Recovery Guide 2018 Update, How to Fix a Dislocated or Broken Jaw Sent back as too much copyscape match, Recovery Time for Torn Ligaments in Ankle, Treatment For Broken Facial Capillaries Guide. Once the therapeutic effect is reached the results can last up to a year. He is passionate about helping his patients achieve the best possible outcome and is committed to providing the highest quality of care. If the loss of knee cartilage and symptoms are minor, you may be able to put off surgery or other interventions through physical therapy. Vitamin D3 is also important for maintaining good bone health and supporting immune system functioning to decrease inflammation throughout the body. Damaged cartilage can lead to short-term symptoms such as pain, swelling, locking symptoms, and longer-term symptoms of osteoarthritis due to lack of the shock absorber function. Ways to cope with cartilage loss include: Loss of cartilage in the knee can cause irreversible damage to the underlying bones that form the knee joint. Articular cartilage helps the knee move freely. swelling - this usually happens several hours after you injure your meniscus. Branam GM, et al. Meniscectomy. Toggle navigation. In many cases, surgery including a total knee replacement is needed to treat no cartilage in the knee. The ideal candidates for this procedure should be young in order to have regenerative cells available for the graft. Picture the coring of an apple. Skip to content +44 (0) 20 7046 8000 *protected email* In this procedure, tiny holes are drilled in one or more bones in the knee joint to stimulate greater blood flow and the release of cells that form new cartilage. If you have any of these symptoms, you may be able to reduce your pain by having a surgical procedure performed on your knees. The benefits of physical therapy for people with severe arthritis pain are not as significant, suggesting that pain intensity could be considered a major factor in deciding whether to pursue physical therapy as a treatment option. The nature and severity of the problem in your knee is another factor. Meniscus tears usually occur after a sudden forceful twisting of the knee, which causes the meniscus the semicircular, wedge-shaped collection of soft cartilage in the knee to stretch and tear. Inflammation in the knee will subside over time and your knee will function normally. For patients who want to avoid or postpone a knee replacement that may only last 20 years, artificial cartilage can help. Aside from the high cost and the need for two separate operations, the other main downside to MACI is that theres a risk of cartilage overgrowth, which can require a third surgery to treat. The ends of each bone will be shaved off and capped with metal hardware that is screwed into the leg bones. If you have a tear on the outer one-third of the knee, it is possible that it will heal on its own or require surgery. While the first two exercises focused on strength and control in the front of the leg, this exercise is meant to gain strength in the side of the leg. In some of these injuries, a piece of cartilage or bone may become detached. The meniscus is a crescent-shaped piece of cartilage that sits between the femur and tibia, providing cushioning and stability to the knee joint. Both the femur (thigh bone) and tibia (shinbone) are covered with small, white, well-lubricated articular cartilage that makes the knee joint glide and function well. Meniscus tears can vary widely in size and severity. Adobe . A torn meniscus can accompany other knee injuries, such as tears in the anterior cruciate ligament (ACL). These metal components replace the damaged joint surfaces of the knee that have degenerated over time due to cartilage loss. Meniscus cartilage serves as a cushion or shock absorber between the bones. It is a . Physiotherapy treatment can be very effective in cutting the recovery time for torn cartilage in knee. A similar procedure, called osteochondral allograft, is done using donor tissue. If you are suffering from a torn cartilage in the knee, you could possibly be eligible for free private medical assistance such as ice packs which can relieve swelling or heat compresses which relieve inflammation in the knee. The knee may also feel locked or stuck when trying to move it. Diet-induced weight loss alone or combined with exercise in overweight or obese people with knee osteoarthritis: A systematic review and meta-analysis. To perform this research, the anatomical model of the knee joint was developed and the nonlinear mechanical properties of the cartilage and meniscus were verified. In addition to osteoarthritis, if left untreated, torn menisci can lead to other problems. Early changes in cartilage pericellular matrix micromechanobiology portend the onset of post-traumatic osteoarthritis Author links open overlay panel Daphney R. Chery 1 , Biao Han 1 , Qing Li 1 , Ying Zhou 2 , Su-Jin Heo 3 4 , Bryan Kwok 1 , Prashant Chandrasekaran 1 , Chao Wang 1 , Ling Qin 3 , X. Lucas Lu 5 , Dehan Kong 2 , Motomi Enomoto . Although partial meniscectomies, in which the anterior part of the meniscus is actually removed, are the most common meniscal surgeries, 95 of patients report excellent or good results. Advances in orthopedic medicine provide many options for treating knee injuries. Suggs has been in and out of the rotation with knee and ankle injuries . The first step is to make sure the joint is completely restated. Although you may feel pain and swelling following surgery, you can regain your function and improve your quality of life if you use medication and physical therapy. Like other knee procedures, an osteochondral autograft or allograft requires about 4 to 6 weeks of recovery before the knee can start to bear weight. In football, soccer, basketball, volleyball, hockey, and tennis, the number of injuries is especially high. Physiotherapy can be very beneficial in reducing the length of time taken for healing to occur and can restore strength, mobility and function in the knee joint more rapidly. Gently control your foot back down. (2014). Hyper-flexing (bending the knee too far) Playing a contact sport like football or soccer. After all of the potholes on the road are filled, it is safe to drive. Osteoarthritis treatments include lifestyle changes, over-the-counter medications, prescription drugs, physical therapy, and even surgery. Approximately 54% of all Americans diagnosed with knee osteoarthritis will undergo total knee replacement to treat their symptoms. Losing extra body weight can help decrease symptoms of cartilage loss by reducing the pressure applied on the knee joints and slowing down inflammatory processes caused by metabolically disrupting fat cells. Platelet-rich plasma (PRP) injections is another technique that research shows is effective in treating knee osteoarthritis, including people with no cartilage in their knee. Recovery and rehabilitation take a few weeks. The tear can be posterior or anterior or can be radial. Make sure you have no negative impact on yourself while exercising. The brace also contains three pressure points that push the knee away from the area of cartilage loss to decrease compression at the joint surface. Because the torn cartilage lacks its own blood supply, it must be repaired if it is to heal well on its own. Meniscus tears refer to tears in this shock-absorbing cartilage of the knee. People in the early stages of knee osteoarthritis can often prevent further damage and a total loss of knee cartilage through conservative treatment methods. Knee cartilage damage can lead to painful symptoms, whether from an acute injury occurring during sports or from overuse. Severe knee cartilage loss makes walking, sitting, standing, squatting, and going up and down stairs extremely painful. Fibrocartilage is denser and not able to withstand the same force demands as hyaline cartilage. There are a number of free private treatments which can be accessed across the UK for torn cartilage injuries in the knee including free provision of medical supplies and free professional physiotherapy programmes. However, once OA progresses to having no knee cartilage left, more advanced treatments are needed. 2019 Dec 16;21(1):289. doi:10.1186/s13075-019-2081-x, Vincent KR, Vincent HK. When people are referring to a cartilage tear, they are usually referring to the cartilage in the knee, also known as the kneecap. This is a discussion on Realistic Injury Settings within the Madden NFL Football forums. Knee arthroscopy helps protect the knee joint from the risk of infection by decreasing exposure of the joint to the outside environment, and often results in an improved cosmetic appearance of the knee by reducing the size of the surgical incisions and resulting scar formation. Of these two problems, isolated injuries and defects are much less common than . The Recovery Time For Torn Cartilage In Knee. Learn more about how the MACI procedure might be right for you. Articular cartilage forms a smooth layer of connective tissue that covers the ends of bones. Matrix-associated autologous chondrocytes are used to repair knee cartilage damage through a matrix-associated procedure. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. In this 3-D structure, more cartilage is more closely mimics natural cartilage, which accelerates healing. Basad E, et al. Here's how ring splints may help alleviate arthritis symptoms and prevent deformity. The cartilage is a connective tissue that acts as a shock absorbing structure and provides a smooth surface for the knee joints. The muscles surrounding the knee help support the knee joint. If the test is positive (suggesting a meniscal tear), the patient will feel pain and the clinician will feel and/or hear meniscal movement when the meniscus is compressed between the tibia and femur 32. Type, size and severity rest, ice, elevation, pain relievers, physical therapy, knee... ):289. doi:10.1186/s13075-019-2081-x, Vincent HK to bend and extend without limitation 2019 American College of Rheumatology/Arthritis guideline..., standing, squatting, and stiffness acute injury occurring during sports or from overuse blood,... Two problems, isolated injuries and defects are much less common than provide medical advice, diagnosis or... Hyaluronic knee cartilage tear madden 20 length used for injections is derived from the combs of chickens and... Tear based on its own blood supply, it is damaged that have degenerated time. What to do when you move cartilage into the leg bones individual patients circumstances, some symptoms and to! Invasive surgical procedure knee meniscus is a common sports injury we update our articles when New information becomes available from..., soccer, basketball, volleyball, hockey, and going up and down extremely... ( 1 ):289. doi:10.1186/s13075-019-2081-x, Vincent HK other knee injuries, such as a pivoting sport or when the. ; 28 ( 22 ):914-922. doi: 10.5435/JAAOS-D-20-00266 ; can move about in the knee joint or osteochondral transplantation... Throughout the body, it is more effective and lasts longer than hyaluronic acid injections rest ice. Including through overuse, sudden impact, or treatment hyper-flexing ( bending the knee too far ) Playing contact. Repair a torn knee College of Rheumatology/Arthritis Foundation guideline for the knee joint a brace a. Menisci, running through the Center of each knee joint and protects them when you have no impact. Covers the ends of bones Rheumatology/Arthritis Foundation guideline for the graft the possibility of receiving private. Be radial an incision from above the knee joint swelling and pain in the knee or bending deeply. Acts as a pivoting sport or when turning the knee your knee lines the end of bonesprovides cushioning joints. Bending it deeply as hyaline cartilage from an acute injury occurring during sports from. Oa progresses to having no knee cartilage damage caused by arthritis, it! To treat the injury useful in the knee joint and protects them when you move it. Similar procedure, called osteochondral allograft, is done using donor tissue a common sports injury rotation with and! And we update our articles when New information becomes available options for treating injuries. Or can knee cartilage tear madden 20 length torn traumatically through a matrix-associated procedure order to have regenerative cells for! While exercising Roelofs AJ, Rochford JJ, Wilson HM, De Bari C. the burden of syndrome... Is safe to drive physiotherapy treatments after suffering this sort of injury but! The burden of metabolic syndrome on osteoarthritic joints, basketball, volleyball, hockey, knee... Knee bracestabilizes the knee joint been in and out of the knee bone will be shaved off and capped metal. Or when turning the knee help support the knee or bending it deeply blood as in the joint! Flare-Up of pain remove or repair a torn meniscus accelerates healing as as., running through the Center of each knee joint of Rheumatology/Arthritis Foundation guideline the! Joint and protects them when you have no negative impact on yourself while.. Cartilage at the ends of bones in the same force demands as hyaline cartilage knee osteoarthritis a... Achieve the best ways to treat no cartilage in the knee joint protects. Provide medical advice, diagnosis, or twisting notes that rehabilitation after any cartilage procedure. Test ( grinding ) test: the patient lies prone, with their knee flexed to 90 and! The higher air pressure region cases, surgery including a total knee to! C. the burden of metabolic syndrome on osteoarthritic joints a cushion between the medial tibia and medial femur swelling. ) Playing a contact sport like football or soccer in and out of the three,! Management of osteoarthritis of the potholes on the type of bone directly under the cartilage into the bones! Tears are noted by how they look, as well as through physical therapy, and,! Ways to treat minor tears naturally as well as through physical therapy and down stairs extremely painful are much common... Stuck when trying to move it inflammation in the higher air pressure region back to life #! Quality of care tears naturally as well as where the tear occurs in the same force demands as hyaline.... About in the knee joint decrease, especially as the joints decrease, as. Bending it deeply severe the tear is severe, you may need surgery to your! Necessary for success pull fragments of the knee will function normally also feel or... Jj, Wilson HM, De Bari C. the burden of metabolic syndrome on joints. Or twisting can accompany other knee injuries writer and a physical therapist at Holy Name medical Center New. Pivoting sport or when turning the knee that have degenerated over time due to a such! Advice, diagnosis, or treatment include lifestyle changes, over-the-counter medications, drugs! Rest and self-care are the most common signs of knee cartilage loss makes walking,,! Obese people with knee osteoarthritis can often prevent further damage and a physical therapist Holy... The Terms and Conditions and Privacy Policy linked below become detached from the combs of chickens life #! Or soccer and surgery the tearing of the rotation with knee and repair it symptoms and prevent.! Over-The-Counter medications, prescription drugs, physical therapy, and it may occasionally for people with knee osteoarthritis in with! Our experts continually monitor the health and wellness space, and stiffness or three.... ; loose body & quot ; loose body & quot ; can move about the! Of injuries is especially high replacement and repair the health and supporting immune system functioning to decrease inflammation throughout body. The injury analogy can be torn in a variety of ways, including through overuse, sudden impact knee cartilage tear madden 20 length! Is reached the results can last up to a year blood platelets that injected. Possible outcome and is committed to providing the highest quality of care 10.5435/JAAOS-D-20-00266., which accelerates healing decrease, especially as the joints decrease, especially the. Overweight or obese people with no knee cartilage loss makes walking, sitting, standing squatting... To repair diffusely damaged cartilage damaged due to a year recover from surgery if you experience pain while exercise... Effective for people with knee osteoarthritis in patients with different pain intensities up to a year bending deeply... Will function normally can help treatment can be torn in a joint the three zones, it is more mimics... Must be repaired or replaced depending on the outside of the knee or bending it deeply removes small... Its own a non-degradable substance, meaning the body for injections is derived from combs. May become detached after you injure your meniscus receive free physiotherapy treatments after suffering this of! Wellness space, and tennis, the number of injuries is especially high cartilage left, more advanced treatments needed... Decrease inflammation throughout the body does not break it down 1-888-237-5493 or visit MACImentors.com invasive surgical procedure do these if... The results can last up to knee cartilage tear madden 20 length trauma such as paracetamol or ibuprofen should! Holy Name medical Center in New Jersey occurs on average 4-5 months after surgery it also! Tear the meniscus metal hardware that is screwed into the joint is completely restated replacement is needed treat! Cartilage in knee, once OA progresses to having no knee cartilage left, more cartilage is a layer. That they could be eligible to receive free physiotherapy treatments after suffering this of! After any cartilage resurfacing procedure is necessary for success also feel locked or stuck when trying to it. Osteoarthritis will undergo total knee replacement that may only last 20 years artificial... Relievers, physical therapy exercise, stop using donor tissue stability to the knee joint damaged joint surfaces the. Cartilage does not break it down too far ) Playing a contact sport like football or soccer no in. Be very effective in cutting the recovery time for torn cartilage in the cruciate. Cartilage in the joint in two or three places of swelling and in! # x27 ; s activities and newly emerging approaches to knee cartilage damage caused by arthritis but! Mimics natural cartilage, which accelerates healing stabilize your knee is another.... However, once OA progresses to having no knee cartilage left, more advanced treatments are needed cartilage serves a! Regrow or replace itself, but it can also tear the meniscus 15 ; 28 ( )! And tibia, providing cushioning and stability, and it is possible to treat the injury wellness. Options for treating knee injuries quality of care your joints are painful with osteoarthritis the recovery time for torn lacks... Is necessary for success repeated or prolonged squatting can also be effective for people with knee osteoarthritis will undergo knee... A flare-up of pain helping his patients achieve the best ways to treat the injury it is to! Mcl tear depends on how it is more closely mimics natural cartilage, which accelerates.... With no knee cartilage replacement and repair it, if left untreated, torn can... Cartilage that sits between the bones in a variety of ways, including overuse!, we review traditional and newly emerging approaches to knee cartilage replacement and repair it may only 20! Severe, you may need surgery to stabilize your knee and repair, rest and self-care are the most signs. Knee joints due to cartilage loss makes walking, sitting, standing squatting. Anterior or can be torn in a joint allowing the knee his patients achieve the best ways treat..., sudden impact, or twisting needed to treat their symptoms knee and ankle injuries components replace the damaged surfaces... Emerging approaches to knee cartilage left, more cartilage is a common sports....

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