Restoration of Articular Cartilage

Current Concepts Review

THE JOURNAL OF BONE AND JOINT SURGERY

Cathal J. Moran, MD, FRCS(Orth), Cecilia Pascual-Garrido, MD, Susan Chubinskaya, PhD, Hollis G. Potter, PhD, Russell F. Warren, MD, Brian J. Cole, MD, MBA, and Scott A. Rodeo, MD

Investigation performed at the Hospital for Special Surgery, New York, NY, and Rush University Medical Center, Chicago, Illinois

medical.cartrestore

  • Novel (i.e., quantitative and semiquantitative) cartilage imaging techniques can evaluate cartilage composition to augment information obtained from traditional magnetic resonance imaging sequences that detail morphology.
  • A well-defined role for drugs leading to chondroprotection has not yet been determined.
  • Shortcomings of bone marrow stimulation include limited production of hyaline repair tissue, unpredictable repair cartilage volume, and a negative impact on later cellular transplantation if required.
  • The role of biological augments, such as cellular concentrates or platelet-rich plasma, remains undefined. When their use is reported in the literature, it is important that their process of production and characterization be detailed.
  • Rehabilitation programs, incorporating controlled exercise and progressive partial weight-bearing, are an important part of cartilage repair surgery and should be detailed in reports on operative techniques applied.
  • Malalignment, meniscal injury, and ligament deficiency should be corrected in a staged or concomitant fashion to reduce the overall likelihood of mechanical failure in cartilage repair surgery. [read complete article]