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From the American Academy of Orthopaedic Surgeons

New Techniques to Restore Articular Cartilage

Meniscal Tears

The Knee

Articular Cartilage Defect
by Nigel M. Azer, MD; Tim Bryant, RN, BSN; Tom Minas, MD, MS

Because mature articular cartilage is avascular, it is unable to regenerate or repair itself. Thus, when healing is attempted by penetration of the subchondral bone plate to obtain a vascular response, the lesions are filled with biomechanically inferior fibrocartilage. Untreated, these cartilage lesions may progress to osteoarthritis, which is particularly problematic for young patients who wish to maintain a high level of activity and function. Articular injuries are extremely common in today's active society. Full-thickness articular cartilage lesions secondary to work or sporting activities account for 5% to 10% of all acute hemarthrosis of the knee. There are numerous treatment approaches and algorithms for the treatment of articular cartilage lesions.

This article reviews clinical considerations in articular cartilage defects and reviews management options in detail, including lavage and debridement; cartilage repair: marrow stimulation; cartilage reconstruction: transplantation of articular cartilage; autologous chondrocyte implantation; osteotomy, and arthroplasty.

Keywords: chondral lesions, chondral defects, chondral injuries, partial-thickness cartilage injuries, full-thickness cartilage injuries, articular cartilage lesions, osteochondral lesions, osteochondral defects, osteochondral injuries, hyaline cartilage defects, incidence, clinical presentation, diagnosis, imaging, diagnostic arthroscopy, MRI, arthrography, management, surgical treatment, surgical techniques, arthroscopy, arthroscopic lavage and joint debridement, cartilage repair, osteochondral autologous transfer, osteoarticular autograft transfer surgery, OATS, mosaicplasty, meniscal allograft, autologous chondrocyte implantation, osteotomy, unicompartmental tibiofemoral arthroplasty, patellofemoral arthroplasty, indications, contraindications, outcomes, complications, rehabilitation

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