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Review
. 2010 Jun;34(5):621-30.
doi: 10.1007/s00264-010-0959-y. Epub 2010 Feb 18.

Treatment of articular cartilage lesions of the knee

Mazen Falah  1 , Gabreil Nierenberg, Michael Soudry, Morris Hayden, Gershon Volpin
Affiliations
Review

Treatment of articular cartilage lesions of the knee

Mazen Falah et al. Int Orthop. 2010 Jun.

Abstract

Treatment of articular cartilage lesions in the knee remains a challenge for the practising orthopaedic surgeon. A wide range of options are currently practised, ranging from conservative measures through various types of operations and, recently, use of growth factors and emerging gene therapy techniques. The end result of these methods is usually a fibrous repair tissue (fibrocartilage), which lacks the biomechanical characteristics of hyaline cartilage that are necessary to withstand the compressive forces distributed across the knee. The fibrocartilage generally deteriorates over time, resulting in a return of the original symptoms and occasionally reported progression to osteoarthritis. Our purpose in this study was to review the aetiology, pathogenesis and treatment options for articular cartilage lesions of the knee. At present, autologous cell therapies, growth factor techniques and biomaterials offer more promising avenues of research to find clinical answers.

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Figures

Fig. 1
Fig. 1
Subchondral drilling. a High speed drilling through trabecular bone. b Fibrin clot filling the crater
Fig. 2
Fig. 2
Stages of ACI. Surgical options for early arthritis in young persons and athletes: the role of meniscus transplants, microfracture, osteoarticular transplants (OATs), autologous chondrocyte implantation (ACI) and osteotomy
Fig. 3
Fig. 3
Surgical stage of matrix-induced autologous chondrocyte implantation (MACI) in patellar chondral lesion. a Debridement and shaping of chondral lesion. b Sizing of lesion for preparing of the membrane. c Filling the crater with fibrin glue. d Pressing the membrane and looking for air bubbles and glue leak before moving the knee
See this image and copyright information in PMC

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