Articular cartilage defects in the knee of young or active individuals remain a problem in orthopaedic practice.

Junji Iwasa and Lars Engebretsen from the Oslo Sports Trauma Research Center, have contributed to the book "Practice of Arthroscopic Surgery" published in Chinese. 

Introduction

These defects have limited ability to heal and may progress to osteoarthritis. These may be symptomatic and cause pain, swelling and catching. Several different surgical procedures have been applied to treat cartilage injuries, but no method has been judged superior. One such attempt was the method of autologous chondrocyte implantation (ACI), described by Brittberg et al. in 1994 (1). This represented the start of in vitro cell based tissue engineering in clinical orthopedics. At present, more than 4,000 Medline citations are available on surgical cartilage treatment, but only five randomized clinical trials have been published (2-6). Three of these studies show that cell transplantation produces similar results as two other much used and less expensive techniques; microfracture and mosaicplasty. In approximately 75% of the patients, these three techniques improve symptoms assessed using patient-centered global outcome scores. This paper reviews current surgical strategies in the treatment of cartilage injuries. Keep in mind that the methods discussed are used for cartilage injuries only and not for osteoarthritis.

Authors
Junji Iwasa, Department of Orthopaedic Surgery, Shimane University School of Medicine, Shimane, Japan
Lars Engebretsen, Orthopedic Center, Ullevaal University Hospital and Faculty of Medicine, Oslo, Norway

Click here to download "Chapter 10: Cartilage repair of the knee" (pdf)