Hyaline articular cartilage is critical for the normal functioning of the knee joint. Untreated focal cartilage defects have the potential to rapidly progress to diffuse osteoarthritis. Over the last several decades, a variety of interventions aiming at preserving articular cartilage and preventing osteoarthritis have been investigated. Reparative cartilage procedures, such as microfracture, penetrate the subchondral bone plate in effort to fill focal cartilage defects with marrow elements and stimulate fibrocartilaginous repair. In contrast, restorative cartilage procedures aim to replace the defective articular surface with autologous or allogeneic hyaline cartilage. This review focuses on the preservation of articular cartilage, and discusses the current reparative and restorative surgical techniques available for treating focal cartilage defects.
*Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
†Department of Orthopedic Surgery, Loma Linda University, Loma Linda, CA
Disclosure: B.J.C. is currently receiving stock options from Aqua Boom, Biometrix, Giteliscope, Ossio, and Regentis. He is receiving royalties from DJ Orthopedics, Elsevier Publishing, Operative Techniques in Sports Medicine, and Arthrex Inc. He is receiving research support from Aesculap/B. Braun, Arthrex Inc., Geistlich, National Institutes of Health (NIAMS & NICHD), Sanofi-Aventis, and Zimmer. He is a paid consultant for Arthrex Inc., Flexion, Regentis, Smith & Nephew, and Zimmer. The remaining authors declare no conflict of interest.
Reprints: Brian J. Cole, MD, MBA, Department of Orthopedic Surgery, Rush University Medical Center, 1611 W. Harrison St. Suite 300, Chicago, IL 60612.