Aim: Review the pathogenesis, aetiology and mainly the treatment options of focal chondral lesions of the knee.

 

Data sources: A survey was conducted in several s, including Cochrane Library, Bandolier, DARE, TRIP , PubMed, ScienceDirect and Ebsco, with articles published between 1959 and 2013.

 

Data synthesis: The treatment of hyaline cartilage lesions poses a challenge, due to its inability of regeneration, considering its lack of vascular supply. A wide variety of options is currently available, since conservative modalities to various surgical techniques. We analyzed these options’ indications and results, characterizing revascularization, palliative and substitution techniques. We summarized this information in one treatment algorithm which we think could give a precious contribute for a better approach.

 

Conclusions: The treatment option selected (conservative or surgical) should consider the degree, size and localization of the lesion, combining also data related to age, level of activity and patients’ expectations. The modern techniques of auto-transplant, either mosaicplasty or either chondrocytes cultures, show promising results in more advanced lesions.

 

 

Keywords: articular cartilage; knee injuries; chondral defects; focal chondral defects; microfracture; mosaicplasty; chondrocyte implantation; gene therapy