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Review
. 2021 Apr 7;103(7):629-645.
doi: 10.2106/JBJS.20.01161.

Chondral Lesions of the Knee: An Evidence-Based Approach

Travis J Dekker  1 , Zachary S Aman  2 , Nicholas N DePhillipo  3 , Jonathan F Dickens  4 , Adam W Anz  5 , Robert F LaPrade  3
Affiliations
Review

Chondral Lesions of the Knee: An Evidence-Based Approach

Travis J Dekker et al. J Bone Joint Surg Am. .

Abstract

➤: Management of chondral lesions of the knee is challenging and requires assessment of several factors including the size and location of the lesion, limb alignment and rotation, and the physical and mental health of the individual patient.

➤: There are a multitude of options to address chondral pathologies of the knee that allow individualized treatment for the specific needs and demands of the patient.

➤: Osteochondral autograft transfer remains a durable and predictable graft option in smaller lesions (<2 cm2) in the young and active patient population.

➤: Both mid-term and long-term results for large chondral lesions (≥3 cm2) of the knee have demonstrated favorable results with the use of osteochondral allograft or matrix-associated chondrocyte implantation.

➤: Treatment options for small lesions (<2 cm2) include osteochondral autograft transfer and marrow stimulation and/or microfracture with biologic adjunct, while larger lesions (≥2 cm2) are typically treated with osteochondral allograft transplantation, particulated juvenile articular cartilage, or matrix-associated chondrocyte implantation.

➤: Emerging technologies, such as allograft scaffolds and cryopreserved allograft, are being explored for different graft sources to address complex knee chondral pathology; however, further study is needed.

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Conflict of interest statement

Disclosure: The authors indicated that no external funding was received for any aspect of this work. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked “yes” to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work and “yes” to indicate that the author had other relationships or activities that could be perceived to influence, or have the potential to influence, what was written in this work (http://links.lww.com/JBJS/G306).

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