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. 2015 Nov 16;47(1):12-20.
doi: 10.1016/S2255-4971(15)30339-6. eCollection 2012 Jan-Feb.

UPDATING ON DIAGNOSIS AND TREATMENT OF CHONDRAL LESION OF THE KNEE

Filho Marcantonio Machado da Cunha Cavalcanti  1 , Daniel Doca  2 , Moisés Cohen  3 , Mário Ferretti  4
Affiliations

UPDATING ON DIAGNOSIS AND TREATMENT OF CHONDRAL LESION OF THE KNEE

Filho Marcantonio Machado da Cunha Cavalcanti et al. Rev Bras Ortop. .

Abstract

The treatment of chondral knee injuries remains a challenge for the orthopedic surgeon, mainly owing to the characteristics of the cartilage tissue, which promote low potential for regeneration. Chondral lesions can be caused by metabolic stimulation, or by genetic, vascular and traumatic events, and are classified according to the size and thickness of the affected cartilage. Clinical diagnosis can be difficult, especially due to insidious symptoms. Additional tests, as Magnetic Resonance Imaging (MRI), may be needed. The treatment of these lesions usually starts with non-operative management. Surgery should be reserved for patients with detached chondral fragments, blocked range of motion, or the failure of non-operative treatment. The surgical techniques used for the treatment of partial thickness defects are Debridement and Ablation. These techniques aim to improve symptoms, since they do not restore normal structure and function of the cartilage. For full-thickness defects (osteochondral lesion), available treatments are Abrasion, Drilling, Microfracture, Osteochondral Autologous and Allogeneic Transplantation, and biological techniques such as the use of Autologous Chondrocyte Transplantation, Minced Cartilage and stem cells.

Keywords: Arthroscopy; Articular Cartilage; Cartilage Diseases; Knee.

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Figures

Figure 1
Figure 1
NMR with T1 weighting (A) and T2 weighting (B) on the patient of the radiographs in photo 1 (B and C), showing appearance of chondral lesion that was not seen on the radiographs. The lesion is seen better with T2 weighting.
Figure 2
Figure 2
Showing at letter A, cartilage without lesion; B, grade III chondral lesion; C, grade IV osteochondral lesion.
Figure 3
Figure 3
(A) Microfracture in the region of the femoral trochlea; (B) Mosaicplasty on the medial femoral condyle.
See this image and copyright information in PMC

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