Treatment Options for Articular Cartilage Defects of the Knee

Abstract

The treatment of symptomatic articular cartilage defects of the knee has evolved tremendously in the past decade. Previously, there were limited treatment options available to patients who suffered from either partial-thickness or full-thickness cartilage lesions. Because articular cartilage has a limited capacity for healing, patients were often treated symptomatically until they became candidates for osteotomy or total joint replacement. Recently, both reparative and restorative procedures have been developed to address this significant source of morbidity in young active patients. Microfracture is a reparative technique that induces a healing response to occur in an area of articular cartilage damage. Osteochondral autografts and allografts in addition to autologous chondrocyte implantation are restorative techniques aimed at recreating a more normal articular surface. Both types of procedures have been developed to alleviate the symptoms associated with focal chondral defects, as well as limit their potential to progress to a diffuse degenerative arthritis. Treatment can vary depending on both cartilage defect and patient factors. This article summarizes the various treatment options that have recently become available.

RECENT RESEARCH ON THE GROWTH PLATE: Mechanisms for growth plate injury repair and potential cell-based therapies for regeneration

“…The concept of this transplantation involves the collection of healthy chondrocytes from a donor or patient, the ex vivo expansion, followed by their re-implantation into the patient. As allogeneic chondrocyte transplantation involves the removal of chondrocytes from one host followed by the transplantation of chondrocytes into another host (Toolan et al 1998), it has the obvious disadvantages of the high risk of disease transmission from one source to the other (Detterline et al 2005). Autologous chondrocyte transplantation, on the other hand, requires the removal of chondrocytes from one host followed by the re-implantation of ex vivo-expanded cells back into the same host.…”

Cartilage Matrix Formation by Bovine Mesenchymal Stem Cells in Three-dimensional Culture Is Age-dependent

“…A major portion of the population will have cartilage pathology, including osteoarthritis [20]. Short of total joint arthroplasty, current treatments for traumatic cartilage injury and disease such as microfracture or osteochondral autografting offer satisfactory short-term solutions without evidence of long-term function [15,27,44]. Autologous chondrocyte implantation (ACI) uses in vitro expanded chondrocytes for implantation into a defect, but also fails to produce functional, integrated repairs [28,34,35].…”

Atualização no diagnóstico e tratamento das lesões condrais do joelho

“…Physiotherapy maintains the range of motion, promotes nutrition for the cartilage and strengthens the affected limb (21) . The medications that have been used for pain relief include analgesics and non-steroid anti-inflammatory drugs (NSAIDs).…”