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Treatment of Focal Cartilage Defects of the Knee: Classic and New Procedures

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Knee Arthroscopy and Knee Preservation Surgery

Abstract

Symptomatic cartilage lesions are a complex problem that can negatively affect quality of life, especially in young patients. The treatment of cartilage defects is multifactorial and should be formulated on a patient-specific basis based on activity level, age, lesion size, and quality in addition to the potential economic burden of available treatments. Current surgical options consist of marrow-based techniques, chondrocyte-based techniques, osteochondral scaffolds, and mature hyaline cartilage. This chapter provides a clear and contemporary description of the current cartilage lesion strategies and proposes and algorithm to guide the decision-making process of the orthopaedic surgeon in determining a successful treatment plan based upon the current literature.

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References

  1. Farr J, Gomoll AH. 2016 barriers to cartilage restoration. J Clin Orthop Trauma. 2016;7(3):183–6.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Flanigan DC, Harris JD, Trinh TQ, Siston RA, Brophy RH. Prevalence of chondral defects in athletes’ knees: a systematic review. Med Sci Sports Exerc. 2010;42(10):1795–801.

    Article  PubMed  Google Scholar 

  3. Perera JR, Gikas PD, Bentley G. The present state of treatments for articular cartilage defects in the knee. Ann R Coll Surg Engl. 2012;94(6):381–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Everhart JS, Boggs Z, AC DB, Wright B, Flanigan DC. Knee Cartilage defect characteristics vary among symptomatic recreational and competitive scholastic athletes eligible for cartilage restoration surgery. Cartilage. 2019;12(2):146–54.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Jungmann PM, Gersing AS, Baumann F, Holwein C, Braun S, Neumann J, et al. Cartilage repair surgery prevents progression of knee degeneration. Knee Surg Sports Traumatol Arthrosc. 2019;27(9):3001–13.

    Article  PubMed  Google Scholar 

  6. Messner K, Maletius W. The long-term prognosis for severe damage to weight-bearing cartilage in the knee: a 14-year clinical and radiographic follow-up in 28 young athletes. Acta Orthop Scand. 1996;67(2):165–8.

    Article  CAS  PubMed  Google Scholar 

  7. Krych AJ, Pareek A, King AH, Johnson NR, Stuart MJ, Williams RJ 3rd. Return to sport after the surgical management of articular cartilage lesions in the knee: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2017;25(10):3186–96.

    Article  PubMed  Google Scholar 

  8. Werner BC, Cosgrove CT, Gilmore CJ, Lyons ML, Miller MD, Brockmeier SF, et al. Accelerated return to sport after osteochondral autograft plug transfer. Orthop J Sports Med. 2017;5(4):2325967117702418.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Pareek A, Carey JL, Reardon PJ, Peterson L, Stuart MJ, Krych AJ. Long-term outcomes after autologous chondrocyte implantation: a systematic review at mean follow-up of 11.4 years. Cartilage. 2016;7(4):298–308.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Richter DL, Tanksley JA, Miller MD. Osteochondral autograft transplantation: a review of the surgical technique and outcomes. Sports Med Arthrosc Rev. 2016;24(2):74–8.

    Article  PubMed  Google Scholar 

  11. Garretson RB 3rd, Katolik LI, Verma N, Beck PR, Bach BR, Cole BJ. Contact pressure at osteochondral donor sites in the patellofemoral joint. Am J Sports Med. 2004;32(4):967–74.

    Article  PubMed  Google Scholar 

  12. Krych AJ, Harnly HW, Rodeo SA, Williams RJ 3rd. Activity levels are higher after osteochondral autograft transfer mosaicplasty than after microfracture for articular cartilage defects of the knee: a retrospective comparative study. J Bone Joint Surg Am. 2012;94(11):971–8.

    Article  PubMed  Google Scholar 

  13. Everhart JS, Campbell AB, Abouljoud MM, Kirven JC, Flanigan DC. Cost-efficacy of knee cartilage defect treatments in the United States. Am J Sports Med. 2020;48(1):242–51.

    Article  PubMed  Google Scholar 

  14. Vanlauwe J, Saris DB, Victor J, Almqvist KF, Bellemans J, Luyten FP. Five-year outcome of characterized chondrocyte implantation versus microfracture for symptomatic cartilage defects of the knee: early treatment matters. Am J Sports Med. 2011;39(12):2566–74.

    Article  PubMed  Google Scholar 

  15. Saris DB, Vanlauwe J, Victor J, Almqvist KF, Verdonk R, Bellemans J, et al. Treatment of symptomatic cartilage defects of the knee: characterized chondrocyte implantation results in better clinical outcome at 36 months in a randomized trial compared to microfracture. Am J Sports Med. 2009;37(Suppl 1):10s–9s.

    Article  PubMed  Google Scholar 

  16. Gou GH, Tseng FJ, Wang SH, Chen PJ, Shyu JF, Weng CF, et al. Autologous chondrocyte implantation versus microfracture in the knee: a meta-analysis and systematic review. Arthroscopy. 2020;36(1):289–303.

    Article  PubMed  Google Scholar 

  17. Riboh JC, Cvetanovich GL, Cole BJ, Yanke AB. Comparative efficacy of cartilage repair procedures in the knee: a network meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2017;25(12):3786–99.

    Article  PubMed  Google Scholar 

  18. Solheim E, Hegna J, Inderhaug E. Long-term survival after microfracture and mosaicplasty for knee articular cartilage repair: a comparative study between two treatments cohorts. Cartilage. 2020;11(1):71–6.

    Article  PubMed  Google Scholar 

  19. Migliorini F, Eschweiler J, Maffulli N, Schenker H, Baroncini A, Tingart M, et al. Autologous matrix-induced chondrogenesis (AMIC) and microfractures for focal Chondral defects of the knee: a medium-term comparative study. Life (Basel). 2021;11(3):183.

    PubMed  Google Scholar 

  20. Campbell AB, Pineda M, Harris JD, Flanigan DC. Return to sport after articular cartilage repair in Athletes’ knees: A systematic review. Arthroscopy. 2016;32(4):651–68.e1.

    Article  PubMed  Google Scholar 

  21. Mistry H, Connock M, Pink J, Shyangdan D, Clar C, Royle P, et al. Autologous chondrocyte implantation in the knee: systematic review and economic evaluation. Health Technol Assess. 2017;21(6):1–294.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ibarra C, Villalobos E, Madrazo-Ibarra A, Velasquillo C, Martinez-Lopez V, Izaguirre A, et al. Arthroscopic matrix-assisted autologous chondrocyte transplantation versus microfracture: a 6-year follow-up of a prospective randomized trial. Am J Sports Med. 2021;49(8):2165–76.

    Article  PubMed  Google Scholar 

  23. Gobbi A, Karnatzikos G, Kumar A. Long-term results after microfracture treatment for full-thickness knee chondral lesions in athletes. Knee Surg Sports Traumatol Arthrosc. 2014;22(9):1986–96.

    Article  PubMed  Google Scholar 

  24. Mithoefer K, McAdams T, Williams RJ, Kreuz PC, Mandelbaum BR. Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis. Am J Sports Med. 2009;37(10):2053–63.

    Article  PubMed  Google Scholar 

  25. Pestka JM, Bode G, Salzmann G, Südkamp NP, Niemeyer P. Clinical outcome of autologous chondrocyte implantation for failed microfracture treatment of full-thickness cartilage defects of the knee joint. Am J Sports Med. 2012;40(2):325–31.

    Article  PubMed  Google Scholar 

  26. Van Assche D, Staes F, Van Caspel D, Vanlauwe J, Bellemans J, Saris DB, et al. Autologous chondrocyte implantation versus microfracture for knee cartilage injury: a prospective randomized trial, with 2-year follow-up. Knee Surg Sports Traumatol Arthrosc. 2010;18(4):486–95.

    Article  PubMed  Google Scholar 

  27. Knutsen G, Drogset JO, Engebretsen L, Grøntvedt T, Isaksen V, Ludvigsen TC, et al. A randomized trial comparing autologous chondrocyte implantation with microfracture. Findings at five years. J Bone Joint Surg Am. 2007;89(10):2105–12.

    Article  PubMed  Google Scholar 

  28. Knutsen G, Drogset JO, Engebretsen L, Grøntvedt T, Ludvigsen TC, Løken S, et al. A randomized multicenter trial comparing autologous chondrocyte implantation with microfracture: long-term follow-up at 14 to 15 years. J Bone Joint Surg Am. 2016;98(16):1332–9.

    Article  PubMed  Google Scholar 

  29. Knutsen G, Engebretsen L, Ludvigsen TC, Drogset JO, Grøntvedt T, Solheim E, et al. Autologous chondrocyte implantation compared with microfracture in the knee. A randomized trial. J Bone Joint Surg Am. 2004;86(3):455–64.

    Article  PubMed  Google Scholar 

  30. Lim HC, Bae JH, Song SH, Park YE, Kim SJ. Current treatments of isolated articular cartilage lesions of the knee achieve similar outcomes. Clin Orthop Relat Res. 2012;470(8):2261–7.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Crawford DC, DeBerardino TM, Williams RJ 3rd. NeoCart, an autologous cartilage tissue implant, compared with microfracture for treatment of distal femoral cartilage lesions: an FDA phase-II prospective, randomized clinical trial after two years. J Bone Joint Surg Am. 2012;94(11):979–89.

    Article  PubMed  Google Scholar 

  32. Basad E, Ishaque B, Bachmann G, Stürz H, Steinmeyer J. Matrix-induced autologous chondrocyte implantation versus microfracture in the treatment of cartilage defects of the knee: a 2-year randomised study. Knee Surg Sports Traumatol Arthrosc. 2010;18(4):519–27.

    Article  PubMed  Google Scholar 

  33. Brittberg M, Recker D, Ilgenfritz J, Saris DBF. Matrix-applied characterized autologous cultured chondrocytes versus microfracture: five-year follow-up of a prospective randomized trial. Am J Sports Med. 2018;46(6):1343–51.

    Article  PubMed  Google Scholar 

  34. Kon E, Gobbi A, Filardo G, Delcogliano M, Zaffagnini S, Marcacci M. Arthroscopic second-generation autologous chondrocyte implantation compared with microfracture for chondral lesions of the knee: prospective nonrandomized study at 5 years. Am J Sports Med. 2009;37(1):33–41.

    Article  PubMed  Google Scholar 

  35. Saris D, Price A, Widuchowski W, Bertrand-Marchand M, Caron J, Drogset JO, et al. Matrix-applied characterized autologous cultured chondrocytes versus microfracture: two-year follow-up of a prospective randomized trial. Am J Sports Med. 2014;42(6):1384–94.

    Article  PubMed  Google Scholar 

  36. Weber AE, Locker PH, Mayer EN, Cvetanovich GL, Tilton AK, Erickson BJ, et al. Clinical outcomes after microfracture of the knee: midterm follow-up. Orthop J Sports Med. 2018;6(2):2325967117753572.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Steadman JR, Briggs KK, Matheny LM, Guillet A, Hanson CM, Willimon SC. Outcomes following microfracture of full-thickness articular cartilage lesions of the knee in adolescent patients. J Knee Surg. 2015;28(2):145–50.

    PubMed  Google Scholar 

  38. Steadman JR, Hanson CM, Briggs KK, Matheny LM, James EW, Guillet A. Outcomes after knee microfracture of chondral defects in alpine ski racers. J Knee Surg. 2014;27(5):407–10.

    Article  PubMed  Google Scholar 

  39. Zhang C, Cai YZ, Lin XJ. One-step cartilage repair technique as a next generation of cell therapy for cartilage defects: biological characteristics, preclinical application, surgical techniques, and clinical developments. Arthroscopy. 2016;32(7):1444–50.

    Article  PubMed  Google Scholar 

  40. de Girolamo L, Schönhuber H, Viganò M, Bait C, Quaglia A, Thiebat G, et al. Autologous Matrix-Induced Chondrogenesis (AMIC) and AMIC Enhanced by Autologous Concentrated Bone Marrow Aspirate (BMAC) Allow for stable clinical and functional improvements at up to 9 years follow-up: results from a randomized controlled study. J Clin Med. 2019;8(3):392.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Gracitelli GC, Meric G, Briggs DT, Pulido PA, McCauley JC, Belloti JC, et al. Fresh osteochondral allografts in the knee: comparison of primary transplantation versus transplantation after failure of previous subchondral marrow stimulation. Am J Sports Med. 2015;43(4):885–91.

    Article  PubMed  Google Scholar 

  42. Minas T, Von Keudell A, Bryant T, Gomoll AH. The John Insall award: a minimum 10-year outcome study of autologous chondrocyte implantation. Clin Orthop Relat Res. 2014;472(1):41–51.

    Article  PubMed  Google Scholar 

  43. Lamplot JD, Schafer KA, Matava MJ. Treatment of failed articular cartilage reconstructive procedures of the knee: a systematic review. Orthop J Sports Med. 2018;6(3):2325967118761871.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Riff AJ, Huddleston HP, Cole BJ, Yanke AB. Autologous chondrocyte implantation and osteochondral allograft transplantation render comparable outcomes in the setting of failed marrow stimulation. Am J Sports Med. 2020;48(4):861–70.

    Article  PubMed  Google Scholar 

  45. Brusalis CM, Greditzer HG, Fabricant PD, Stannard JP, Cook JL. BioCartilage augmentation of marrow stimulation procedures for cartilage defects of the knee: two-year clinical outcomes. Knee. 2020;27(5):1418–25.

    Article  PubMed  Google Scholar 

  46. Cameron JI, Pulido PA, McCauley JC, Bugbee WD. Osteochondral allograft transplantation of the femoral trochlea. Am J Sports Med. 2016;44(3):633–8.

    Article  PubMed  Google Scholar 

  47. Hinckel BB, Pratte EL, Baumann CA, Gowd AK, Farr J, Liu JN, et al. Patellofemoral cartilage restoration: a systematic review and meta-analysis of clinical outcomes. Am J Sports Med. 2020;48(7):1756–72.

    Article  PubMed  Google Scholar 

  48. Pareek A, Reardon PJ, Macalena JA, Levy BA, Stuart MJ, Williams RJ 3rd, et al. Osteochondral autograft transfer versus microfracture in the knee: a meta-analysis of prospective comparative studies at midterm. Arthroscopy. 2016;32(10):2118–30.

    Article  PubMed  Google Scholar 

  49. Horas U, Pelinkovic D, Herr G, Aigner T, Schnettler R. Autologous chondrocyte implantation and osteochondral cylinder transplantation in cartilage repair of the knee joint. A prospective, comparative trial. J Bone Joint Surg Am. 2003;85(2):185–92.

    Article  CAS  PubMed  Google Scholar 

  50. Bentley G, Biant LC, Carrington RW, Akmal M, Goldberg A, Williams AM, et al. A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee. J Bone Joint Surg Br. 2003;85(2):223–30.

    Article  CAS  PubMed  Google Scholar 

  51. Bentley G, Biant LC, Vijayan S, Macmull S, Skinner JA, Carrington RW. Minimum ten-year results of a prospective randomised study of autologous chondrocyte implantation versus mosaicplasty for symptomatic articular cartilage lesions of the knee. J Bone Joint Surg Br. 2012;94(4):504–9.

    Article  CAS  PubMed  Google Scholar 

  52. Schrock JB, Kraeutler MJ, Houck DA, McQueen MB, McCarty EC. A cost-effectiveness analysis of surgical treatment modalities for chondral lesions of the knee: microfracture, osteochondral autograft transplantation, and autologous chondrocyte implantation. Orthop J Sports Med. 2017;5(5):2325967117704634.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Ebert JR, Fallon M, Wood DJ, Janes GC. An accelerated 6-week return to full weight bearing after matrix-induced autologous chondrocyte implantation results in good clinical outcomes to 5 years post-surgery. Knee Surg Sports Traumatol Arthrosc. 2021;29(11):3825–33.

    Article  PubMed  Google Scholar 

  54. Kozak T, Bauer S, Walch G, Al-Karawi S, Blakeney W. An update on reverse total shoulder arthroplasty: current indications, new designs, same old problems. EFORT Open Rev. 2021;6(3):189–201.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Gao L, Orth P, Cucchiarini M, Madry H. Autologous matrix-induced chondrogenesis: a systematic review of the clinical evidence. Am J Sports Med. 2019;47(1):222–31.

    Article  PubMed  Google Scholar 

  56. Bennett CH, Nadarajah V, Moore MC, Jauregui JJ, Dubina AG, Burt C, et al. Cartiform implantation for focal cartilage defects in the knee: a 2-year clinical and magnetic resonance imaging follow-up study. J Orthop. 2021;24:135–44.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Ebert JR, Fallon M, Wood DJ, Janes GC. A prospective clinical and radiological evaluation at 5 years after arthroscopic matrix-induced autologous chondrocyte implantation. Am J Sports Med. 2017;45(1):59–69.

    Article  PubMed  Google Scholar 

  58. Shanmugaraj A, Coughlin RP, Kuper GN, Ekhtiari S, Simunovic N, Musahl V, et al. Changing trends in the use of cartilage restoration techniques for the patellofemoral joint: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2019;27(3):854–67.

    Article  PubMed  Google Scholar 

  59. Wang T, Belkin NS, Burge AJ, Chang B, Pais M, Mahony G, et al. Patellofemoral cartilage lesions treated with particulated juvenile allograft cartilage: a prospective study with minimum 2-year clinical and magnetic resonance imaging outcomes. Arthroscopy. 2018;34(5):1498–505.

    Article  PubMed  Google Scholar 

  60. Skowroński J, Skowroński R, Rutka M. Large cartilage lesions of the knee treated with bone marrow concentrate and collagen membrane – results. Ortop Traumatol Rehabil. 2013;15(1):69–76.

    PubMed  Google Scholar 

  61. Gobbi A, Karnatzikos G, Sankineani SR. One-step surgery with multipotent stem cells for the treatment of large full-thickness chondral defects of the knee. Am J Sports Med. 2014;42(3):648–57.

    Article  PubMed  Google Scholar 

  62. Gobbi A, Whyte GP. One-stage cartilage repair using a hyaluronic acid-based scaffold with activated bone marrow-derived mesenchymal stem cells compared with microfracture: five-year follow-up. Am J Sports Med. 2016;44(11):2846–54.

    Article  PubMed  Google Scholar 

  63. Gobbi A, Scotti C, Karnatzikos G, Mudhigere A, Castro M, Peretti GM. One-step surgery with multipotent stem cells and Hyaluronan-based scaffold for the treatment of full-thickness chondral defects of the knee in patients older than 45 years. Knee Surg Sports Traumatol Arthrosc. 2017;25(8):2494–501.

    Article  PubMed  Google Scholar 

  64. Farr J, Yao JQ. Chondral defect repair with particulated juvenile cartilage allograft. Cartilage. 2011;2(4):346–53.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Buckwalter JA, Bowman GN, Albright JP, Wolf BR, Bollier M. Clinical outcomes of patellar chondral lesions treated with juvenile particulated cartilage allografts. Iowa Orthop J. 2014;34:44–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  66. Cavinatto L, Hinckel BB, Tomlinson RE, Gupta S, Farr J, Bartolozzi AR. The role of bone marrow aspirate concentrate for the treatment of focal chondral lesions of the knee: a systematic review and critical analysis of animal and clinical studies. Arthroscopy. 2019;35(6):1860–77.

    Article  PubMed  Google Scholar 

  67. Shasha N, Aubin P, Cheah HK, Davis AM, Agnidis Z, Gross AE. Long-term clinical experience with fresh osteochondral allografts for articular knee defects in high demand patients. Cell Tissue Bank; 2002.

    Google Scholar 

  68. Thomas D, Shaw KA, Waterman BR. Outcomes after fresh osteochondral allograft transplantation for medium to large chondral defects of the knee. Orthop J Sports Med. 2019;7(3):2325967119832299.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Chahla J, Hinckel BB, Yanke AB, Farr J, Bugbee WD, Carey JL, et al. An expert consensus statement on the management of large chondral and osteochondral defects in the patellofemoral joint. Orthop J Sports Med. 2020;8(3):2325967120907343.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Steinhoff AK, Bugbee WD. Outcomes of total knee arthroplasty after osteochondral allograft transplantation. Orthop J Sports Med. 2014;2(9):232596711455027.

    Article  Google Scholar 

  71. Minas T, Ogura T, Headrick J, Bryant T. Autologous chondrocyte implantation “Sandwich” technique compared with autologous bone grafting for deep osteochondral lesions in the knee. Am J Sports Med. 2018;46(2):322–32.

    Article  PubMed  Google Scholar 

  72. Aldrian S, Zak L, Wondrasch B, Albrecht C, Stelzeneder B, Binder H, et al. Clinical and radiological long-term outcomes after matrix-induced autologous chondrocyte transplantation: a prospective follow-up at a minimum of 10 years. Am J Sports Med. 2014;42(11):2680–8.

    Article  PubMed  Google Scholar 

  73. Pareek A, Carey JL, Reardon PJ, Peterson L, Stuart MJ, Krych AJ. Long-term outcomes after autologous chondrocyte implantation. Cartilage. 2016;7(4):298–308.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Familiari F, Cinque ME, Chahla J, Godin JA, Olesen ML, Moatshe G, et al. Clinical outcomes and failure rates of osteochondral allograft transplantation in the knee: a systematic review. Am J Sports Med. 2018;46(14):3541–9.

    Article  PubMed  Google Scholar 

  75. Godin JA, Sanchez G, Cinque ME, Chahla J, Kennedy NI, Provencher MT. Osteochondral allograft transplantation for treatment of medial femoral condyle defect. Arthrosc Tech. 2017;6(4):e1239–e44.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Jones KJ, Cash BM, Arshi A, Williams RJ 3rd. Fresh osteochondral allograft transplantation for uncontained, elongated osteochondritis dissecans lesions of the medial femoral condyle. Arthrosc Tech. 2019;8(3):e267–e73.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Tírico LEP, McCauley JC, Pulido PA, Bugbee WD. Lesion size does not predict outcomes in fresh osteochondral allograft transplantation. Am J Sports Med. 2018;46(4):900–7.

    Article  PubMed  Google Scholar 

  78. Wang D, Ode G, Elbuluk A, Burge A, Jones K, Williams R, et al. One-year MRI outcomes of osteochondral allograft transplantation of the knee for large chondral defects: comparison of elliptical, stacked, and single allografts. Orthop J Sports Med. 2020;8(7 suppl6)

    Google Scholar 

  79. Cotter EJ, Hannon CP, Christian DR, Wang KC, Lansdown DA, Waterman BR, et al. Clinical outcomes of multifocal osteochondral allograft transplantation of the knee: an analysis of overlapping grafts and multifocal lesions. Am J Sports Med. 2018;46(12):2884–93.

    Article  PubMed  Google Scholar 

  80. Ogura T, Bryant T, Merkely G, Minas T. Autologous chondrocyte implantation for bipolar chondral lesions in the patellofemoral compartment: clinical outcomes at a mean 9 Years’ follow-up. Am J Sports Med. 2019;47(4):837–46.

    Article  PubMed  Google Scholar 

  81. Meric G, Gracitelli GC, Görtz S, De Young AJ, Bugbee WD. Fresh osteochondral allograft transplantation for bipolar reciprocal osteochondral lesions of the knee. Am J Sports Med. 2015;43(3):709–14.

    Article  PubMed  Google Scholar 

  82. Peterson L, Vasiliadis HS, Brittberg M, Lindahl A. Autologous chondrocyte implantation: a long-term follow-up. Am J Sports Med. 2010;38(6):1117–24.

    Article  PubMed  Google Scholar 

  83. Farr J, Cole BJ, Sherman S, Karas V. Particulated articular cartilage: CAIS and DeNovo NT. J Knee Surg. 2012;25(1):23–9.

    Article  PubMed  Google Scholar 

  84. Gobbi A, Karnatzikos G, Scotti C, Mahajan V, Mazzucco L, Grigolo B. One-step cartilage repair with bone marrow aspirate concentrated cells and collagen matrix in full-thickness knee cartilage lesions: results at 2-year follow-up. Cartilage. 2011;2(3):286–99.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Cole BJ, Farr J, Winalski CS, Hosea T, Richmond J, Mandelbaum B, et al. Outcomes after a single-stage procedure for cell-based cartilage repair:a prospective clinical safety trial with 2-year follow-up. Am J Sports Med. 2011;39(6):1170–9.

    Article  PubMed  Google Scholar 

  86. Massen FK, Inauen CR, Harder LP, Runer A, Preiss S, Salzmann GM. One-step autologous minced cartilage procedure for the treatment of knee joint chondral and osteochondral lesions: a series of 27 patients with 2-year follow-up. Orthop J Sports Med. 2019;7(6):2325967119853773.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Fortier LA, Chapman HS, Pownder SL, Roller BL, Cross JA, Cook JL, et al. BioCartilage improves cartilage repair compared with microfracture alone in an equine model of full-thickness cartilage loss. Am J Sports Med. 2016;44(9):2366–74.

    Article  PubMed  Google Scholar 

  88. Lee YH, Suzer F, Thermann H. Autologous matrix-induced Chondrogenesis in the knee: a review. Cartilage. 2014;5(3):145–53.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Pestka JM, Feucht MJ, Porichis S, Bode G, Südkamp NP, Niemeyer P. Return to sports activity and work after autologous chondrocyte implantation of the knee: which factors influence outcomes? Am J Sports Med. 2016;44(2):370–7.

    Article  PubMed  Google Scholar 

  90. Nielsen ES, McCauley JC, Pulido PA, Bugbee WD. Return to sport and recreational activity after osteochondral allograft transplantation in the knee. Am J Sports Med. 2017;45(7):1608–14.

    Article  PubMed  Google Scholar 

  91. Agarwalla A, Christian DR, Liu JN, Garcia GH, Redondo ML, Gowd AK, et al. Return to work following high Tibial osteotomy with concomitant osteochondral allograft transplantation. Arthroscopy. 2020;36(3):808–15.

    Article  PubMed  Google Scholar 

  92. Lane JG. Return to work after autologous chondrocyte implantation of the knee in patients with workers compensation insurance. Cartilage. 2021;13(1_suppl):829s–36s.

    Article  CAS  PubMed  Google Scholar 

  93. Nimkingratana P, Brittberg M. Returning to work after articular cartilage repair intervention: a systematic review. Orthop J Sports Med. 2020;8(3):2325967120905526.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Bode G, Ogon P, Pestka J, Zwingmann J, Feucht M, Südkamp N, et al. Clinical outcome and return to work following single-stage combined autologous chondrocyte implantation and high tibial osteotomy. Int Orthop. 2015;39(4):689–96.

    Article  PubMed  Google Scholar 

  95. Scully WF, Parada SA, Arrington ED. Allograft osteochondral transplantation in the knee in the active duty population. Mil Med. 2011;176(10):1196–201.

    Article  PubMed  Google Scholar 

  96. Shaha JS, Cook JB, Rowles DJ, Bottoni CR, Shaha SH, Tokish JM. Return to an athletic lifestyle after osteochondral allograft transplantation of the knee. Am J Sports Med. 2013;41(9):2083–9.

    Article  PubMed  Google Scholar 

  97. Samuelson EM, Brown DE. Cost-effectiveness analysis of autologous chondrocyte implantation: a comparison of periosteal patch versus type I/III collagen membrane. Am J Sports Med. 2012;40(6):1252–8.

    Article  PubMed  Google Scholar 

  98. Lindahl A, Brittberg M, Peterson L. Health economics benefits following autologous chondrocyte transplantation for patients with focal chondral lesions of the knee. Knee Surg Sports Traumatol Arthrosc. 2001;9(6):358–63.

    Article  CAS  PubMed  Google Scholar 

  99. Mistry H, Metcalfe A, Smith N, Loveman E, Colquitt J, Royle P, et al. The cost-effectiveness of osteochondral allograft transplantation in the knee. Knee Surg Sports Traumatol Arthrosc. 2019;27(6):1739–53.

    Article  PubMed  PubMed Central  Google Scholar 

  100. LeBrun D, Feingold J, Swenson-Buza S, Gruber S, Dennis E, Stein BS. Cost-effectiveness of particulated juvenile articular cartilage versus matrix-induced autologous chondrocyte implantation for patellar chondral lesions (176). Orthop J Sports Med. 2021;9(10_suppl 5):2325967121S00295.

    PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Beaumont Health, Royal Oak, MI, USA

    Robert S. Dean, Betina B. Hinckel & Ali Omari

  2. Hospital for Special Surgery, New York City, NY, USA

    Ian Hutchinson & Andreas H. Gomoll

Authors
  1. Robert S. Dean
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  2. Betina B. Hinckel
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  3. Ali Omari
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  4. Ian Hutchinson
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  5. Andreas H. Gomoll
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Corresponding author

Correspondence to Andreas H. Gomoll .

Editor information

Editors and Affiliations

  1. Sports Medicine Clinic, Stanford University, Redwood City, CA, USA

    Seth L. Sherman

  2. Orthopaedics, Midwest Orthopaedics at Rush, Chicago, IL, USA

    Jorge Chahla

  3. Complex Knee and Sports Medicine Surgeon, Twin Cities Orthopedics, Edina, MN, USA

    Robert F. LaPrade

  4. Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA

    Scott A. Rodeo

Section Editor information

  1. Professor of Clinical Orthopaedics, Weill-Cornell Medical College, New York, NY 10021, United States

    Andreas Gomoll

  2. Orthopedics and Sports Medicine, Mayo Clinic, Rochester, MN, USA

    Daniel B. Saris

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Dean, R.S., Hinckel, B.B., Omari, A., Hutchinson, I., Gomoll, A.H. (2024). Treatment of Focal Cartilage Defects of the Knee: Classic and New Procedures. In: Sherman, S.L., Chahla, J., LaPrade, R.F., Rodeo, S.A. (eds) Knee Arthroscopy and Knee Preservation Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-29430-3_60

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  • DOI: https://doi.org/10.1007/978-3-031-29430-3_60

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-29429-7

  • Online ISBN: 978-3-031-29430-3

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