Articular cartilage repair of the knee in athletes

Abstract

Athletes are at an elevated risk for articular cartilage injury of the knee, especially in pivoting sports such as soccer and basketball. Due to the poor intrinsic healing response of articular cartilage, these injuries can be debilitating and even career threatening for high level athletes. Athletes often damage their articular cartilage in conjunction with other pathology such as an anterior cruciate ligament tear or meniscus tear, and these typically need to be addressed at the same time as the articular cartilage. Fortunately, there are an increasing number of surgical treatment options available to restore the articular cartilage of the knee. Outcomes data is still relatively limited, especially for athletes, but there is a growing body of evidence that patients can return to sport after articular cartilage surgery, although the recovery may be lengthy. Microfracture and autologous chondrocyte implantation, and osteochondral autograft to a lesser degree, have demonstrated fair to good rates of return to sport. Appropriate rehabilitation is essential and the quality of the tissue repair appears to be an important factor influencing return to play. Much of the evidence for return to play is in soccer and American football, with less data for other sports. Although promising, more studies are needed to better define and predict return to play and long term outcomes in athletes after articular cartilage surgery in the knee.