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Articular cartilage of the knee is a specialized hyaline connective tissue, composed of chondrocytes (2–5%) and extra-cellular matrix (95–98%). Articular cartilage injuries can be broadly divided into deep (through tidemark) or superficial lacerations (above the tidemark). Deep lacerations have a partial repair potential whereas superficial lacerations have almost no healing potential. MRI with evolving techniques like cartilage-specific- pulse sequences, modified fast spin-echo sequence, dGEMRIC, and T2-mapping (MR Cartigram), is the most sensitive radiological investigation for evaluation of focal cartilage defects. Types of cartilaginous injuries treatment include chondroprotection, chondroreparation, and chondroregeneration. Chondroprotection includes unloader bracing, muscle strengthening, intra-articular corticosteroids, viscosupplementation, growth factors Platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC), reconstruction of injured ligaments and menisci repair. Chondroreparation consists of stimulating the subchondral bone by different modalities: arthroscopic debridement, abrasion chondroplasty, fixation of unstable fragments, drilling, and microfractures/nanofractures. Chondroregeneration is the most exciting frontier in the treatment of cartilage injuries, which includes Osteochondral Autograft Transplantation System (OATS), Osteochondral Allograft (OCA) Transplantation, Autologous Chondrocyte Implantation (ACI), Autologous matrix induced chondrogenesis (AMIC), and newer evolving techniques like micronized cartilage extracellular matrix, Particulated Juvenile autograft cartilage (PJAC), Particulated autologous cartilage implantation (PACI), Mesenchymal/Embryonic/Induced Pluripotent stem cells, Nasal chondrocytes, various scaffolds, and growth factors. Careful patient selection is probably the most important factor, which affects the eventual outcome. The author prefers to perform OATS in cartilage defects <2 cm2 and ACI in larger defects. Exciting developments have been incoming from different parts of the world in the field of cartilage repair and further research is needed to ensure a single gold standard technique for cartilage defects.

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Cartilage Injuries of Femur and Tibia

  • 章节

  • 发表日期：

    2026年

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  • Abhey Wasdev,
  • Rinju Krishnan,
  • Sunil Lakshmipura Krishnamurthy,
  • Rahul Shah,
  • Likhith Theodore,
  • Rajkumar S. Amaravati,
  • A. Hemanth Kumar

摘要

Articular cartilage of the knee is a specialized hyaline connective tissue, composed of chondrocytes (2–5%) and extra-cellular matrix (95–98%). Articular cartilage injuries can be broadly divided into deep (through tidemark) or superficial lacerations (above the tidemark). Deep lacerations have a partial repair potential whereas superficial lacerations have almost no healing potential. MRI with evolving techniques like cartilage-specific- pulse sequences, modified fast spin-echo sequence, dGEMRIC, and T2-mapping (MR Cartigram), is the most sensitive radiological investigation for evaluation of focal cartilage defects. Types of cartilaginous injuries treatment include chondroprotection, chondroreparation, and chondroregeneration. Chondroprotection includes unloader bracing, muscle strengthening, intra-articular corticosteroids, viscosupplementation, growth factors Platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC), reconstruction of injured ligaments and menisci repair. Chondroreparation consists of stimulating the subchondral bone by different modalities: arthroscopic debridement, abrasion chondroplasty, fixation of unstable fragments, drilling, and microfractures/nanofractures. Chondroregeneration is the most exciting frontier in the treatment of cartilage injuries, which includes Osteochondral Autograft Transplantation System (OATS), Osteochondral Allograft (OCA) Transplantation, Autologous Chondrocyte Implantation (ACI), Autologous matrix induced chondrogenesis (AMIC), and newer evolving techniques like micronized cartilage extracellular matrix, Particulated Juvenile autograft cartilage (PJAC), Particulated autologous cartilage implantation (PACI), Mesenchymal/Embryonic/Induced Pluripotent stem cells, Nasal chondrocytes, various scaffolds, and growth factors. Careful patient selection is probably the most important factor, which affects the eventual outcome. The author prefers to perform OATS in cartilage defects <2 cm2 and ACI in larger defects. Exciting developments have been incoming from different parts of the world in the field of cartilage repair and further research is needed to ensure a single gold standard technique for cartilage defects.