Knee Surg Relat Res.  2011 Dec;23(4):185-196. 10.5792/ksrr.2011.23.4.185.

Management of Focal Chondral Lesion in the Knee Joint

• Seo SS
• Kim CW
• Jung DW

• KMID: 2297848
• DOI: http://doi.org/10.5792/ksrr.2011.23.4.185

Abstract

Articular cartilage does not contain vascular, nervous and lymphatic tissue and chondrocytes hardly participate in the healing or repair process of chondral tissue because of being surrounded by plenty of extracellular matrix. Therefore, the injury to articular cartilage frequently requires an operative treatment. The goal of surgical repair of articular cartilage is to regenerate nearly normal chondral tissue and prevent degenerative arthritis caused by the articular cartilage defect. Microfracture is a kind of cartilage repair procedure that makes a fibrin clot containing mesenchymal stem cells in the chondral lesion. Microfracture is a simple procedure but it has a disadvantage that the repaired tissue is fibrocartilage. Autologous chondrocyte implantation has an advantage that it implants fully differentiated chondrocytes to the lesion, which theoretically produces hyaline cartilage. Its disadvantages are that it is a two stage and a costly procedure. Osteochondral autograft transplantation is a one stage procedure and repairs the lesion with hyaline cartilage. But its limitation is the lack of donor site availability. Surgeons who understand the theoretical background, indications, surgical methods, rehabilitation, complications, and clinical course of cartilage repair procedures can achieve the goal of preventing degenerative arthritis.

Keyword

Knee joint; Articular cartilage; Focal chondral lesion; Management

MeSH Terms

Cartilage
Cartilage, Articular
Chondrocytes
Extracellular Matrix
Fibrin
Fibrocartilage
Humans
Hyaline Cartilage
Imidazoles
Knee
Knee Joint
Lymphoid Tissue
Mesenchymal Stromal Cells
Nitro Compounds
Osteoarthritis
Tissue Donors
Transplants
Fibrin
Imidazoles
Nitro Compounds