PMID: 9533054Apr 9, 1998Paper

Current treatment options for the restoration of articular cartilage

The American Journal of Knee Surgery
J E Gilbert

Abstract

Over the past several decades, much has been learned about articular cartilage and its physiological capacity to restore itself. While articular cartilage does appear to have some regenerative capabilities, it appears to lose this capacity over a period of time, making restoration of articular surfaces more and more difficult. To date, no technique has been completely successful in achieving exactly normal regenerative articular cartilage. Arthroscopic lavage and debridement provides temporary relief of symptoms. This probably works by removing degradative enzymes that contribute to synovitis and also to the further breakdown of articular cartilage. Bone marrow stimulation techniques such as abrasion arthroplasty, drilling, and microfracture produce only fibrocartilage and therefore do not offer a long-term cure. Perichondral and periosteal interposition grafts produce repair tissue that is similar to hyaline cartilage but also lack the mechanical durability. Like bone marrow stimulation techniques, interposition grafts introduce precursor cells, which have a tendency to differentiate along lines other than cartilage. This leads to an inferior quality of repair tissue. Currently, chondrogenic-stimulating factors and artificial ...Continue Reading

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