Treatment of Isolated Cartilage Lesions of the Knee

Articular cartilage defects have poor healing capacity and can lead to osteoarthritis. Treatment strategies for isolated cartilage lesions of the knee are discussed with a special focus on natural history and evidence of the effectiveness of procedures. Many approaches have been undertaken during the last two decades to find treatments for biological repair of the cartilage surface. Surgical techniques include debridement, stimulation by microfracture, mosaicplasty, autologous chondrocyte implantation (ACI) and autologous matrix-induced chondrogenesis (AMIC). Although these treatments are promising and scientifically interesting, there is no evidence for a breakthrough in cartilage repair. The evidence justifies cartilage repair procedures in patients with symptomatic full-thickness lesions and in patients with large defects in the weightbearing surface of the knee joint.