What Is a Chondral Fissure?

A chondral fissure is a narrow crack that appears on articular knee cartilage in Grade II or Grade III chondral knee injuries. Articular cartilage covers knee surfaces but has no connections to the nervous system, so injuries do not cause pain at first, which can make them hard to detect.

Chondral fissures generally develop gradually, often existing for years before they are detected. The most common symptom is swelling of the knee, although pain when climbing stairs or while walking for long periods of time may also be an indication that a person has developed it. Knees that catch or lock while moving, buckle under the full weight of the body or make noise when moving may also have chondral damage.

Grade I damage does not show fissures but manifests as an increase in softness. In Grades II and III, the articular cartilage has more of a shredded look; in Grade II, the fissures that appear are smaller than 1.5 centimeters across. In Grade III, the fissures have a wider diameter, and they often go all the way to the bone. With Grade IV damage, the cartilage can tear off altogether; this leads to intense pain and places severe limits on activity.