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.