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Articular Cartilage: Injury Pathways and Treatment Options

Simon, Timothy M. PhD; Jackson, Douglas W. MD

Sports Medicine and Arthroscopy Review: September 2006 - Volume 14 - Issue 3 - p 146-154
Review Articles
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Articular cartilage injury and degeneration is a frequent occurrence in synovial joints. Treatment of these articular cartilage lesions are a challenge because this tissue is incapable of quality repair and/or regeneration to its native state. Nonoperative treatments endeavor to control symptoms, and include anti-inflammatory medication, viscosupplementation, bracing, orthotics, and activity modification. Techniques to stimulate the intrinsic repair (fibrocartilage) process include drilling, abrasion, and microfracture of the subchondral bone. Currently, the clinical biologic approaches to treat cartilage defects include autologous chondrocyte implantation, periosteal transfer, and osteochondral autograft or allograft transplantation. Newer strategies employing tissue engineering being studied involve the use of combinations of progenitor cells, bioactive factors, and matrices, and the use of focal synthetic devices. Many new and innovative treatments are being explored in this exciting field. However, there is a paucity of prospective, randomized controlled clinical trials that have compared the various techniques, treatment options, indications and efficacy.

Orthopaedic Research Institute and the Southern California Center for Sports Medicine, Long Beach, CA

Sources of support: The Douglas W. Jackson Orthopaedic Research Trust supported the studies referenced and conducted in the Orthopaedic Research Institute's laboratories located in the Long Beach Memorial Medical Center Research Facility.

Reprints: Dr Timothy M. Simon, PhD, Orthopaedic Research Institute at the Southern California Center for Sports Medicine, 2760 Atlantic Avenue, Long Beach, CA, 90806 (e-mail: simori@aol.com).

© 2006 Lippincott Williams & Wilkins, Inc.