Clinical Orthopaedics and Related Research®

, Volume 470, Issue 8, pp 2261–2267 | Cite as

Current Treatments of Isolated Articular Cartilage Lesions of the Knee Achieve Similar Outcomes

  • Hong-Chul Lim
  • Ji-Hoon Bae
  • Sang-Heon Song
  • Young-Eun Park
  • Seung-Ju KimEmail author
Clinical Research



Many surgical techniques, including microfracture, periosteal and perichondral grafts, chondrocyte transplantation, and osteochondral grafts, have been studied in an attempt to restore damaged articular cartilage. However, there is no consensus regarding the best method to repair isolated articular cartilage defects of the knee.


We compared postoperative functional outcomes, followup MRI appearance, and arthroscopic examination after microfracture (MF), osteochondral autograft transplantation (OAT), or autologous chondrocyte implantation (ACI).


We prospectively investigated 30 knees with MF, 22 with OAT, and 18 with ACI. Minimum followup was 3 years (mean, 5 years; range, 3–10 years). We included only patients with isolated cartilage defects and without other knee injuries. The three procedures were compared in terms of function using the Lysholm knee evaluation scale, Tegner activity scale, and Hospital for Special Surgery (HSS) score; modified Outerbridge cartilage grades using MRI; and International Cartilage Repair Society (ICRS) repair grade using arthroscopy.


All three procedures showed improvement in functional scores. There were no differences in functional scores and postoperative MRI grades among the groups. Arthroscopy at 1 year showed excellent or good results in 80% after MF, 82% after OAT, and 80% after ACI. Our study did not show a clear benefit of either ACI or OAT over MF.


Owing to a lack of superiority of any one treatment, we believe MF is a reasonable option as a first-line therapy given its ease and affordability relative to ACI or OAT.

Level of Evidence

Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.


Articular Cartilage Cartilage Defect Autologous Chondrocyte Implantation Osteochondritis Dissecans Articular Cartilage Defect 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© The Association of Bone and Joint Surgeons® 2012

Authors and Affiliations

  • Hong-Chul Lim
    • 1
  • Ji-Hoon Bae
    • 1
  • Sang-Heon Song
    • 1
  • Young-Eun Park
    • 1
  • Seung-Ju Kim
    • 1
    Email author
  1. 1.Korea University Medical CenterGuro HospitalSeoulSouth Korea

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