Management of knee articular cartilage injuries in athletes: chondroprotection, chondrofacilitation, and resurfacing

  • Iain R. MurrayEmail author
  • Michael T. Benke
  • Bert R. Mandelbaum


Articular cartilage defects of the knee are common among athletes where the physical demands of sport result in significant stresses on joints. Chondral defects are associated with pain and functional impairment that limit sporting participation and may progress to joint degeneration and frank arthritis. Management of established chondral lesions aims to allow athletes to return to high-impact sports and can be considered in terms of protection of existing cartilage, chondrofacilitation, and resurfacing. Repaired and regenerated cartilage must closely resemble and function like normal hyaline cartilage, and this ability may be the most significant factor for the return to sport. Based on our experiences and the available literature, we outline how athletes can best protect their cartilage, how physicians can facilitate intrinsic repair of established lesions, and which methods of cartilage restoration or resurfacing should be used in different situations.

Level of evidence



Cartilage injury Return to sport Knee articular cartilage Cartilage resurfacing 



The authors are grateful to Mr Ivan Brenkel for his comments on the manuscript.


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2015

Authors and Affiliations

  • Iain R. Murray
    • 1
    Email author
  • Michael T. Benke
    • 2
  • Bert R. Mandelbaum
    • 3
  1. 1.Department of Trauma and OrthopaedicsThe University of EdinburghEdinburghUK
  2. 2.Active Orthopaedics and Sports MedicineHackensackUSA
  3. 3.Santa Monica Orthopaedic and Sports Medicine GroupSanta MonicaUSA

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