The present state of treatments for articular cartilage defects in the knee

Chondral and osteochondral lesions of the knee are notoriously difficult to treat due to the poor healing capacity of articular cartilage and the hostile environment of moving joints, ultimately causing disabling pain and early osteoarthritis. There are many different reconstructive techniques used...

Full description

Saved in:
Bibliographic Details
Published in:Annals of the Royal College of Surgeons of England 2012-09, Vol.94 (6), p.381-387
Main Authors: Perera, J R, Gikas, P D, Bentley, G
Format: Article
Language:English
Subjects:
Arthritis
Biomedical materials
Bone marrow
Cartilage Diseases - diagnosis
Cartilage Diseases - therapy
Cartilage, Articular
Cell adhesion & migration
Chondrocytes - transplantation
Collagen
Defects
Forecasting
Friction
Humans
Intercellular Signaling Peptides and Proteins - therapeutic use
Joint Diseases - diagnosis
Joint Diseases - therapy
Knee
Knee Joint
Mesenchymal Stem Cell Transplantation - methods
Metabolism
NMR
Nuclear magnetic resonance
Osteoarthritis, Knee - therapy
Review
Stem cells
Surgery
Tissue engineering
Tissue Scaffolds
Transplantation, Autologous
Transplantation, Homologous
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Chondral and osteochondral lesions of the knee are notoriously difficult to treat due to the poor healing capacity of articular cartilage and the hostile environment of moving joints, ultimately causing disabling pain and early osteoarthritis. There are many different reconstructive techniques used currently but few are proven to be of value. However, some have been shown to produce a better repair with hyaline-like cartilage rather than fibrocartilage. A systematic search of all available online databases including PubMed, MEDLINE(®) and Embase™ was undertaken using several keywords. All the multiple treatment options and methods available were considered. These were summarised, and the evidence for and against them was scrutinised. A total of 460 articles were identified after cross-referencing the database searches using the keywords. These revealed that autologous and matrix assisted chondrocyte implantation demonstrated both 'good to excellent' histological results and significant improvement in clinical outcomes. Autologous and matrix assisted chondrocyte implantation have been shown to treat symptomatic lesions successfully with significant histological and clinical improvement. There is, however, still a need for further randomised clinical trials, perfecting the type of scaffold and the use of adjuncts such as growth factors. A list of recommendations for treatment and the potential future trends of managing these lesions are given.
ISSN:0035-8843
1478-7083
DOI:10.1308/003588412x13171221592573