Physical therapy management of articular cartilage lesion: a case report

Background and Purpose: Articular cartilage covers bony surfaces of joints to decrease friction. Lesions can be of varying severity and be symptomatic or asymptomatic. Current research has focused on surgical interventions with limited research on conservative management of these lesions. The purpose of this case study is to present conservative treatment and the outcomes of a patient experiencing symptoms related to an articular cartilage lesion. Case Description: Patient is a 41-year-old female referred to Physical Therapy for pain in the right knee. Main complaint was pain during and after running that prevented self-selected running duration and frequency. Findings from evaluation were decreased hip musculature endurance on right compared to left, testing of right gluteus medius resulted in tensor fascia latae compensation, tenderness to palpation at distal medial patella, decreased patellar mobility in all directions and decreased functional dorsiflexion range of motion on the right compared to the left. Interventions included a running program, therapeutic exercise (TE) and correction of body mechanics with functional movement. Outcomes: Patient’s overall pain level and symptoms decreased in intensity and frequency. Patient’s mental health improved on the Short Form-12 Health Survey. The Lysholm Knee Scoring Scale and International Knee Documentation Committee Subjective Knee Form demonstrated improved scores. Discussion: Physical Therapy proved to be an effective strategy to decrease symptoms and improve this patient’s overall function. Primary goal of returning to self-selected running duration and frequency was achieved. Continued research is needed to demonstrate the effect on Physical Therapy on various grades of articular cartilage lesions.