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Chondral (Articular Cartilage) Defects

Articular or hyaline cartilage is the tissue lining the surface of the bones in the knee joint. Cartilage helps the bones move smoothly against each other and can withstand the weight of the body during impact activities, such as running and jumping. Articular cartilage does not have a direct blood supply to it so has less capacity to repair itself. Once the cartilage is torn, it will not heal easily and this can lead to degeneration of the articular surface, leading to development of osteoarthritis.

Damage to articular cartilage can affect people of all ages. It can be damaged by trauma such as accidents, mechanical injury such as a fall or twist, or from degenerative joint disease (osteoarthritis).
Patients with articular cartilage damage experience symptoms such as joint pain, swelling, stiffness and a decrease in range of motion of the knee. Damaged/missing cartilage may need to be replaced and the procedures which attempt to do this are known as cartilage replacement procedures. These are surgical procedures which are performed to replace the worn out cartilage and are usually performed to treat patients with small areas of cartilage damage usually caused by sports or traumatic injuries. Cartilage repair is not indicated for those patients who have advanced arthritis of knee.

Cartilage replacement helps relieve pain, restore normal function, and may delay or prevent the onset of arthritis. The goal of cartilage replacement procedures is to stimulate growth of new ‘hyaline-like’ cartilage. Various arthroscopic procedures which can have an active role in cartilage replacement include:

  • Microfracture surgery
  • Subchondral Drilling
  • Abrasion Chondroplasty
  • Autologous chondrocyte implantation (ACI)
  • Matrix Autologous chondrocyte implantation (MACI)
  • Osteochondral Autograft Transplantation (OATS)
RCS Logo British Orthopaedic AssociationRoyal College of Surgeons of EdinburghOTSISBritish Association for knee surgeryISOAMDU LogoOTSIS