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Articular cartilage regeneration in the knee

McAdams, Timothy Ra; Mandelbaum, Bert Rb

Current Opinion in Orthopaedics: January 2008 - Volume 19 - Issue 1 - p 37–43
doi: 10.1097/BCO.0b013e3282f333a9
Knee reconstruction: Edited by Robert S. Sterling

Purpose of review: Articular cartilage lesions in the active population are observed with increasing frequency and result from the significant acute and chronic joint stress associated with high-impact sports. Current surgical options for articular cartilage injury include repair (debridement), replacement (osteochondral autograft or allograft transplantation), and regeneration (autologous chondrocyte implantation). We describe the indications and technique for autologous chondrocyte implantation, and discuss its importance in the prevention of progressive chondropenia.

Recent findings: Autologous chondrocyte implantation may provide autologous hyaline-like tissue for large chondral lesions, but limitations include possible periosteal hypertrophy and the need for a staged procedure. Researchers are now focusing on matrix articular cartilage implantation, which involves a biodegradable matrix seeded with chondrocytes to cover the defect. Matrix articular cartilage implantation can be done in a single procedure and does not require use of a periosteal flap.

Summary: Early clinical results for articular cartilage regeneration techniques are encouraging. Long-term studies in this population will determine the efficacy of articular cartilage repair to reverse chondropenia and to prevent development of secondary arthritic degeneration.

aDepartment of Orthopaedic Surgery, Stanford University, Palo Alto, USA

bSanta Monica Orthopedic and Sports Medicine Foundation, Los Angeles, California, USA

Correspondence to Timothy R. McAdams, MD, Assistant Professor, Department of Orthopaedic Surgery, Stanford University, 1000 Welch Road, Suite 100, Palo Alto, CA 94304, USA Tel: +1 650 498 6202; fax: +1 650 736 9588; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.