Surgical treatment of cartilage lesions in the knee: A narrative review

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Purpose The treatment of cartilage injury is challenging owing to its low self-healing capacity. Here we describe a literature review of the current diagnostic methods, surgical treatment options, and techniques for knee cartilage injuries, including possible future treatments and augmentations. Methods Studies describing surgical techniques for knee cartilage injuries were searched and arbitrarily selected in PubMed. Possible future treatments and augmentations, growth factors, and cell-based treatments are also discussed. Results Surgical options for cartilage injury, such as microfracture, osteochondral autografts or allografts, and autologous chondrocyte implantation, are well-established methods with overall satisfactory short- and long-term outcomes. However, the limitations and disadvantages of these treatments, such as repair with fibrous cartilage, donor site morbidity, and two-step surgery, have raised concerns. Various surgical treatments or augmentations have been developed to overcome these limitations, including autologous matrix-induced chondrogenesis, bone marrow aspirate concentrate, particulate chondrocyte implantation, and particulate juvenile allograft chondrocytes, and promising short-to mid-term results have been reported. Additionally, numerous studies are underway on the augmentation of biological healing including growth factor and stem cell therapies. Conclusions Although treating cartilage injuries remains challenging, advancements have been made. It is advisable for surgeons and clinicians to update their surgical techniques and knowledge of cartilage repair and regeneration to better treat patients with knee cartilage injuries.

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