[Surgery on articular cartilage: from debridement to tissue engineering]

Abstract

Articular cartilage is a complex tissue with a limited endogenous repair capacity. Surgical strategies to stimulate repair of damaged cartilage are presently evolving extensively. New techniques based on tissue-engineering principles with cultured cells and scaffolds are challenging established techniques based on generating a repair response from the bone marrow. This paper reviews treatments such as debridement, marrow-stimulating techniques, osteochondral transplantation and autologous chondrocyte transplantation. Debridement and marrow stimulation can provide significant relief of symptoms. Recently, randomized studies have uncovered some of the clinical effects of the new biotechnology-based surgical methods. However, no significant advances over the established surgical techniques have been developed.