Current Status of Articular Cartilage Repair

Abstract

Articular cartilage injury is a common problem that is frequently encountered by practising Orthopaedic Surgeons [1]. Following a retrospective review of 31,516 knee arthroscopies, Curl et al., reported that cartilage lesions were present in 63% of the procedures [2]. More recently, Widuchowski et al., reported similar results, with chondral lesions found in 60% of 25,124 patients who underwent knee arthroscopies [3]. Importantly, both studies reported that patients with lesions had a mean age of approximately 40 years [2, 3]. As it is widely accepted that patients who experience a traumatic cartilage injury when they are young, have a high risk of developing osteoarthritis later in life, effective early treatment of symptomatic cartilage defects is vital to minimise the risk of degeneration of the damaged joint [4–6]. The treatment goals of articular cartilage defects in the knee include replacement, regeneration, or repair methods that result in hyaline tissue that integrates with native host tissue and functions durably under load and over time, and most importantly provides an asymptomatic joint [7–9]. The treatment of chondral defects is challenging, with repair techniques rapidly evolving. Due to its avascular nature and extracellular matrix structure, articular cartilage has a limited intrinsic capacity for healing after injury [1].