Operative Techniques in Sports Medicine

Jun-Kyo Suh, PhD, Steve Scherping, MD, Takashi Marui, MD, J. Richard Steadman, MD, and Savio L. Y. Woo, PhD


Although cartilage tissue is surprisingly resilient in response to compression and shear, it also is remarkably durable. However, once damaged, the cartilage has limited or no ability to heal and often undergoes degenerative pathological changes. Complete understanding of the mechanisms and natural history of cartilage injuries, and the healing and regeneration of injured cartilage is lacking. In this article, we will discuss articular cartilage damage, healing mechanisms, and current experimental and clinical techniques to promote healing of damaged cartilage. Although a few successful clinical outcomes have been reported, current surgical treatments are widely believed to have a limited ability to completely restore the characteristics of hyaline cartilage. Nonetheless, recent experimental studies have shown that the successful repair of a clinically significant articular cartilage injury may be possible. Therapies could include a combination of growth factors, cell technologies, and allograft transplantation. Further study is needed to develop these techniques and define their clinical value. KEY WORDS: articular cartilage, cartilage injury, cartilage repair, osteoarthritis.