Skip to main content
SpringerLink
Log in

Knee Cartilage Repair

  • Chapter
Football Traumatology

  • 1340 Accesses

Abstract

The incidence of the injuries of knee articular cartilage is found to be increasing among athletes, especially of contact sports like football. It has been shown that foul play is responsible for about 30 % of all injuries and that knee injuries are among the most common injuries and may be career ending.

A careful assessment of the patient-player is required along with a detailed discussion of the treatment options, the possibilities, the anticipated outcomes and all the parameters related to the anticipated rehabilitation time, the complication rate and the potential long term impact on the knee joint. The treatment strategy is usually individualized according to many factors, including the priorities of the patient-athlete. There are three main treatment groups that may differ in the approach and treatment possibilities and also prognosis; the teenage player in the beginning of his career, the established player in his active career between 20–35 years and the player in the end of his career or post career.

Generally, the currently available evidence shows a superiority of ACI in terms of return to sports, return to preinjury levels and durability of good outcomes. However, the ACI is a two stage operation, associated with a longer and more demanding rehabilitation protocol. On the other hand, although MF is associated with a less postoperative morbidity and a short term good outcome may be observed, it is associated with a lower sports performance, higher rate of retirement and long term deterioration of the clinical outcomes. Regarding MP-OATS, although good results have been reported, there is not much evidence to allow for safe conclusions.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mithoefer K, Williams RJ, Warren RF, Wickiewicz TL, Marx RG (2006) High-impact athletics after knee articular cartilage repair: a prospective evaluation of the microfracture technique. Am J Sports Med 34:1413–1418

    Article  PubMed  Google Scholar 

  2. Noyes FR, Bassett RW, Grood ES, Butler DL (1980) Arthroscopy in acute traumatic hemarthrosis of the knee. Incidence of anterior cruciate tears and other injuries. J Bone Joint Surg Am 62:687–695, 757

    CAS  PubMed  Google Scholar 

  3. Curl WW, Krome J, Gordon ES, Rushing J, Smith BP, Poehling GG (1997) Cartilage injuries: a review of 31,516 knee arthroscopies. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 13:456–460

    Article  CAS  Google Scholar 

  4. Hjelle K, Solheim E, Strand T, Muri R, Brittberg M (2002) Articular cartilage defects in 1,000 knee arthroscopies. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 18:730–734

    Article  Google Scholar 

  5. Mithoefer K, Hambly K, Della Villa S, Silvers H, Mandelbaum BR (2009) Return to sports participation after articular cartilage repair in the knee: scientific evidence. Am J Sports Med 37(Suppl 1):167S–176S

    Article  PubMed  Google Scholar 

  6. Piasecki DP, Spindler KP, Warren TA, Andrish JT, Parker RD (2003) Intraarticular injuries associated with anterior cruciate ligament tear: findings at ligament reconstruction in high school and recreational athletes. An analysis of sex-based differences. Am J Sports Med 31:601–605

    PubMed  Google Scholar 

  7. Brophy RH, Rodeo SA, Barnes RP, Powell JW, Warren RF (2009) Knee articular cartilage injuries in the National Football League: epidemiology and treatment approach by team physicians. J Knee Surg 22:331–338

    Article  PubMed  Google Scholar 

  8. Noyes FR, Mooar PA, Matthews DS, Butler DL (1983) The symptomatic anterior cruciate-deficient knee. Part I: the long-term functional disability in athletically active individuals. J Bone Joint Surg Am 65:154–162

    CAS  PubMed  Google Scholar 

  9. Drawer S, Fuller CW (2001) Propensity for osteoarthritis and lower limb joint pain in retired professional soccer players. Br J Sports Med 35:402–408

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Kujala UM, Kettunen J, Paananen H, Aalto T, Battié MC, Impivaara O, Videman T, Sarna S (1995) Knee osteoarthritis in former runners, soccer players, weight lifters, and shooters. Arthritis Rheum 38:539–546

    Article  CAS  PubMed  Google Scholar 

  11. Harris JD, Brophy RH, Siston RA, Flanigan DC (2010) Treatment of chondral defects in the athlete’s knee. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 26:841–852

    Article  Google Scholar 

  12. Gudas R, Stankevicius E, Monastyreckiene E, Pranys D, Kalesinskas RJ (2006) Osteochondral autologous transplantation versus microfracture for the treatment of articular cartilage defects in the knee joint in athletes. Knee Surg Sports Traumatol Arthrosc Off ESSKA 14:834–842

    Article  Google Scholar 

  13. Steadman JR, Miller BS, Karas SG, Schlegel TF, Briggs KK, Hawkins RJ (2003) The microfracture technique in the treatment of full-thickness chondral lesions of the knee in National Football League players. J Knee Surg 16:83–86

    PubMed  Google Scholar 

  14. Namdari S, Baldwin K, Anakwenze O, Park M-J, Huffman GR, Sennett BJ (2009) Results and performance after microfracture in National Basketball Association athletes. Am J Sports Med 37:943–948

    Article  PubMed  Google Scholar 

  15. Cerynik DL, Lewullis GE, Joves BC, Palmer MP, Tom JA (2009) Outcomes of microfracture in professional basketball players. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 17:1135–1139

    Article  Google Scholar 

  16. Cole BJ, Pascual-Garrido C, Grumet RC (2009) Surgical management of articular cartilage defects in the knee. J Bone Joint Surg Am 91:1778–1790

    PubMed  Google Scholar 

  17. Nagel A, Insall JN, Scuderi GR (1996) Proximal tibial osteotomy. A subjective outcome study. J Bone Joint Surg Am 78:1353–1358

    CAS  PubMed  Google Scholar 

  18. Peterson L, Vasiliadis HS, Brittberg M, Lindahl A (2010) Autologous chondrocyte implantation: a long-term follow-up. Am J Sports Med 38:1117–1124

    Article  PubMed  Google Scholar 

  19. Peterson L (2003) Autologous Chondrocyte Implantation, In; Master Techniques in Orthopaedic Surgery: Reconstructive Knee Surgery. Second Edition. Douglas W. Jackson (Ed). Lippincott Williams & Wilkins, Philadelphia, 2002; 353–373

    Google Scholar 

  20. Peterson L (2009) Autologous chondrocyte implantation. In: Noyes FR (ed) Noyes knee disord surg rehabil clin outcomes saunders https://books.google.gr/books?id=s-4cvT0c3E8C&dq=Peterson+L+%282009%29+Autologous+chondrocyte+implantation.+In:+Noyes+FR+%28ed%29+Noyes+knee+disord+surg+rehabil+clin+outcomes+saunders&lr=&source=gbs_navlinks_s

  21. Peterson L (2003) Articular Cartilage lesions in football players. In; Football Traumatology: Current Concepts: from Prevention to Treatment. Piero Volpi (ed), Springer Milan, pp 255–261

    Google Scholar 

  22. Mithöfer K, Peterson L, Mandelbaum BR, Minas T (2005) Articular cartilage repair in soccer players with autologous chondrocyte transplantation: functional outcome and return to competition. Am J Sports Med 33:1639–1646

    Article  PubMed  Google Scholar 

  23. Mithöfer K, Minas T, Peterson L, Yeon H, Micheli LJ (2005) Functional outcome of knee articular cartilage repair in adolescent athletes. Am J Sports Med 33:1147–1153

    Article  PubMed  Google Scholar 

  24. Vanlauwe J, Saris DB, Victor J, Almqvist KF, Bellemans J, Luyten FP, TIG ACT (2011) Five-year outcome of characterized chondrocyte implantation versus microfracture for symptomatic cartilage defects of the knee: early treatment matters. Am J Sports Med 39:2566–2574

    Article  PubMed  Google Scholar 

  25. De Windt TS, Bekkers JEJ, Creemers LB, Dhert WJA, Saris DBF (2009) Patient profiling in cartilage regeneration: prognostic factors determining success of treatment for cartilage defects. Am J Sports Med 37(Suppl 1):58S–62S

    Article  PubMed  Google Scholar 

  26. Knutsen G, Drogset JO, Engebretsen L, Grøntvedt T, Isaksen V, Ludvigsen TC, Roberts S, Solheim E, Strand T, Johansen O (2007) A randomized trial comparing autologous chondrocyte implantation with microfracture. Findings at five years. J Bone Joint Surg Am 89:2105–2112

    Article  PubMed  Google Scholar 

  27. Riyami M, Rolf C (2009) Evaluation of microfracture of traumatic chondral injuries to the knee in professional football and rugby players. J Orthop Surg 4:13

    Article  Google Scholar 

  28. Minas T, Gomoll AH, Rosenberger R, Royce RO, Bryant T (2009) Increased failure rate of autologous chondrocyte implantation after previous treatment with marrow stimulation techniques. Am J Sports Med 37:902–908

    Article  PubMed  Google Scholar 

  29. Peterson L, Brittberg M, Kiviranta I, Akerlund EL, Lindahl A (2002) Autologous chondrocyte transplantation. Biomechanics and long-term durability. Am J Sports Med 30:2–12

    PubMed  Google Scholar 

  30. Peterson L, Minas T, Brittberg M, Nilsson A, Sjögren-Jansson E, Lindahl A (2000) Two – to 9-year outcome after autologous chondrocyte transplantation of the knee. Clin Orthop 374:212–234

    Article  PubMed  Google Scholar 

  31. Blevins FT, Steadman JR, Rodrigo JJ, Silliman J (1998) Treatment of articular cartilage defects in athletes: an analysis of functional outcome and lesion appearance. Orthopedics 21:761–767, discussion 767–768

    CAS  PubMed  Google Scholar 

  32. Gobbi A, Nunag P, Malinowski K (2005) Treatment of full thickness chondral lesions of the knee with microfracture in a group of athletes. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 13:213–221

    Article  Google Scholar 

  33. Kon E, Gobbi A, Filardo G, Delcogliano M, Zaffagnini S, Marcacci M (2009) Arthroscopic second-generation autologous chondrocyte implantation compared with microfracture for chondral lesions of the knee: prospective nonrandomized study at 5 years. Am J Sports Med 37:33–41

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Sahlgrenska Academy, Gothenburg University, S413 45, Gothenburg, Sweden

    Lars G. Peterson MD, PhD

  2. Department of Orthopaedics, University of Ioannina, Leoforos Panepistimiou, 45500, Ioannina, Greece

    Haris S. Vasiliadis MD, PhD

Authors
  1. Lars G. Peterson MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Haris S. Vasiliadis MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Lars G. Peterson MD, PhD or Haris S. Vasiliadis MD, PhD .

Editor information

Editors and Affiliations

  1. Knee Orthopaedics and Sport Traumatology Unit, Humanitas Research-IRCCS, Milan, Italy

    Piero Volpi

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Peterson, L.G., Vasiliadis, H.S. (2015). Knee Cartilage Repair. In: Volpi, P. (eds) Football Traumatology. Springer, Cham. https://doi.org/10.1007/978-3-319-18245-2_25

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-18245-2_25

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-18244-5

  • Online ISBN: 978-3-319-18245-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation