A review of the evaluation and management of cartilage defects in the knee.

Overview

In the orthopedic community, there is controversy regarding the management of articular cartilage defects of the knee. Nonoperative treatment is indicated for initial management. Surgical options include autologous chondrocyte implantation, osteochodral autograft transfer, osteoarticular allografts, and microfracture. More than 70% of patients who have surgery using these techniques have reported overall good results, and the literature does not clearly support the use of one technique over another. Treatment recommendations for each technique are based on differences in outcomes with respect to the size of the defect and the relative advantages and disadvantages of each. This article describes an approach to the evaluation and management of cartilage defects of the knee.