Knee cartilage Tibio-femoral injuries

Articular cartilage lesions of the femoral condyles are common and have limited healing capacity. The goal of surgical management is to relieve pain and mechanical symptoms, and hopefully slow the progression of osteoarthritis. Numerous surgical procedures have been described to include chondroplasty, microfracture, autologous chondrocyte implantation, autologous osteochondral transfer, allograft osteochondral transplantation, and fragment fixation. Each technique is distinguished by number of procedures required, expense, donor-site morbidity, risks of allograft tissues, and rehabilitation requirements. To maximize the surgical outcomes, it is imperative to treat any concomitant pathology to include mechanical malalignment, ligamentous instability, and/or meniscal deficiency. Several treatment algorithms have been proposed to guide management of symptomatic, focal chondral injuries of the femoral condyles. Algorithm decisions are based on lesion location, size, patient activity level, and earlier treatment. This article reviews the treatment considerations of the various techniques and the published results and illustrative case examples.