Cartilage Injury in the Knee: Assessment and Treatment Options

Aaron J. Krych, MD; Daniel B. F. Saris, MD, PhD; Michael J. Stuart, MD; Brittney Hacken, MD


J Am Acad Orthop Surg. 2020;28(22):914-922. 

In This Article


Cartilage injuries in the knee are a challenging problem for both patients and physicians. Treatment depends on individual patient characteristics and the lesion location, size, and depth. All concurrent pathology must be addressed, including ligament instability, meniscus deficiency, and limb malalignment for cartilage restoration procedures to be successful. The first goal of any cartilage procedure is to preserve the patient's own cartilage if possible. Patients with small symptomatic lesions <2 cm2 who have failed nonsurgical management are treated with chondroplasty or osteochondral autograft transfer. Larger defects require OCA transplantation, matrix-induced ACI, or PJAC. Continued advances in cartilage restoration procedures will positively provide single stage and cost-effective treatment options for patients in the future.