Abstract
The articular cartilage lesions represent one of the major unsolved problems in the orthopaedic surgery. This is because articular cartilage has a limited capacity of self-repair following trauma. The aim of this study is to review the different surgical options for articular cartilage repair. They can be divided into three groups: techniques without transplant of cells or tissues; techniques based on the transplantation of tissues; the tissue engineering techniques.
The first group includes the joint debridement and the techniques based on the bone marrow-stimulation principle.
The second group includes the transplantation of periosteum and the transplantation of autologous or allogeneic osteochondral plugs. The tissue engineering techniques could be further divided as follows: methods based on the transplantation of cells either in solution, or in the form of microspheres, or carried on a biocompatible scaffold; the transplant of cartilage fragments; the cell-free techniques, based on the use of an acellular scaffold, able to entrap the reparative cells recruited from the host tissue and to guide their differentiation toward a chondral phenotype.
In this work we present various options for the treatment of chondral or osteochondral lesions. Today, however, due to the lack of comparative studies, it is not always possible to define the best treatment choice for the different cartilage pathologies.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Andereya S, Maus U, Gavenis K, Gravius S, Stanzel S, Müller-Rath R, Miltner O, Mumme T, Schneider U (2007) Treatment of patellofemoral cartilage defects utilizing a 3D collagen gel: two-year clinical results. Z Orthop Unfall;145(2):139–45.
Attmanspacher W, Dittrich V, Stedtfeld H (2000) Experiences with arthroscopic therapy of chondral and ostreochondral defect of the knee joint with OATS (Osteochondral Autograft Transfer System). Zentralbl Chir; 125:494–9.
Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L (1994) Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med;331(14):889–95.
Buckwalter JA, Mankin HJ (1997) Articular cartilage. 2: Degeneration and osteoarthrosis, repair, regeneration, and transplantation. J Bone Joint Surg 79A:612–32.
Chao PH, Grayson W, Vunjak-Novakovic G (2007) Engineering cartilage and bone using human mesenchymal stem cells. J Orthop Sci;12(4):398–404.
Cherubino P, Bulgheroni P, Ronga M (2003) Autologous chondrocyte implantation using a bilayer collagen membrane. A preliminary report. J Orthop Surg;11(1):10–5.
Ferruzzi A, Calderoni P, Grigolo B, Gualtieri G (2004) Autologous chondrocytes implantation: indications and results in the treatment of articular cartilage lesions of the knee. Chir Organi Mov; 89(2):125–34.
Grayson WL, Chao PH, Marolt D, Kaplan DL, Vunjak-Novakovic G (2008) Engineering custom-designed osteochondral tissue grafts. Trends Biotechnol;26(4):181–9.
Hunziker EB (2002) Articular cartilage repair: basic science and clinical progress. A review of the current status and prospects. Osteoarthr Cartil;10(6):432–63.
Insall JN (1974) The Pridie debridement operation for osteoarthritis of the knee. Clin Orthop;101:61–7.
Jackson DW, Scheer MJ, Simon TM (2001) Cartilage substitutes: overview of basic science and treatment options. J Am Acad Orthop Surg;9(2):147.
Kessler MW, Ackerman G, Dines JS, Grande D (2008) Emerging technologies and fourth generation issues in cartilage repair. Sports Med Arthrosc;16(4):246–54.
Khan IM, Gilber SJ, Singhrao SK, Duance VC, Archer CW (2008) Cartilage integration: evaluation of the reasons for failure of integration during cartilage repair. A review. Eur Cell Mater;16:26–39.
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(1):33–41.
Kreuz PC Müller S, Ossendorf C, Kaps C, Erggelet C (2009) Treatment of focal degenerative cartilage defects with polymer-based autologous chondrocyte grafts: four-year clinical results. Arthritis Res Ther;11(2):R33.
Magnusson PB (1941) Joint debridement: surgical treatment of degenerative arthritis. Surg Gynaecol Obstet;73:1–9.
Marlovits S, Zeller P, Singer P, Resinger C, Cècsei V (2006) Cartilage repair: generations of autologous chondrocyte transplantation. Eur J Radiol;57(1):24–31.
Martin JA, Buckwalter JA (2001) Telomere erosion and senescence in human articular cartilage chondrocytes. J Gerontol A Biol Sci Med Sci;56(4):B172–9.
Mikos AG, Herring SW, Ochareon P, Elisseeff J, Lu HH, Kandel R, Schoen FJ, Toner M, Mooney D, Atala A, Van Dyke ME, Kaplan D, Vunjak-Novakovic G (2006) Engineering complex tissues. Tissue Eng;12(12):3307–39.
Ochs BG, Müller-Horvat C, Rolauffs B, Fritz J, Weise K, Schewe B (2007) Treatment of osteochondritis dissecans of the knee: one-step procedure with bone grafting and matrix-supported autologous chondrocyte transplantation. Z Orthop Unfall; 145(2):146–51.
Samuels J, Krasnokutsky S, Abramson SB (2008) Osteoarthritis: a tale of three tissues. Bull NYU Hosp Jt Dis;66(3):244–50.
Schreiber RE, Dunkelman NS, Naughton G, Ratcliffe A (1999) A method for tissue engineering of cartilage by cell seeding on bioresorbable scaffolds. Ann NY Acad Sci;875:398–404.
Selmi TA, Verdonk P, Chambat P, Dubrana F, Potel JF, Barnouin L, Neyret P (2008) Autologous chondrocyte implantation in a novel alginate-agarose hydrogel: outcome at two years. J Bone Joint Surg Br;90(5):597–604.
Shapiro F, Koide S, Glimcher MJ (1993) Cell origin and differentiation in the repair of full-thickness defects of articular cartilage. J Bone Joint Surg Am;75(4):532–53.
Simon TM, Jackson DW (2006) Articular cartilage: injury pathways and treatment options. Sports Med Arthrosc;14(3):146–54.
Tognana E, Borrione A, De Luca C, Pavesio A (2007) Hyalograft C: hyaluronan-based scaffolds in tissue-engineered cartilage. Cells Tissues Organs 186(2):97–103.
Wakitani S, Kawaguchi A, Tokuhara Y, Takaoka K (2008) Present status of and future direction for articular cartilage repair. J Bone Miner Metab;26(2):115–22.
Williams RJ, Gamradt SC (2008) Articular cartilage repair using a resorbable matrix scaffold. Instr Course Lect ;57:563–71.
Conflicts of Interest Statement We declare that we have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag/Wien
About this chapter
Cite this chapter
Peretti, G.M., Pozzi, A., Ballis, R., Deponti, D., Pellacci, F. (2011). Current Surgical Options for Articular Cartilage Repair. In: Alexandre, A., Masini, M., Menchetti, P. (eds) Advances in Minimally Invasive Surgery and Therapy for Spine and Nerves. Acta Neurochirurgica Supplementum, vol 108. Springer, Vienna. https://doi.org/10.1007/978-3-211-99370-5_33
Download citation
DOI: https://doi.org/10.1007/978-3-211-99370-5_33
Published:
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-99369-9
Online ISBN: 978-3-211-99370-5
eBook Packages: MedicineMedicine (R0)