Cartilage Injuries in the Knee

Cartilage injuries of the knee are common and are associated with 66% of patients undergoing knee arthroscopies. It is also associated with up to 46% of patients with acute ACL injuries. The treatment of cartilage injuries is crucial to preserve healthy articular cartilage to reduce and prevent degenerative joint disease. Patients can present with a history of trauma in 30% of cases, with the most common site affected being the patella and medial femoral condyle. Osteochondritis dissecans (OCD) affects mainly the adolescent group, with patients presenting young, skeletally immature providing the best prognosis. MRI scan remains the gold standard imaging modality and is best imaged under contrast enhancement. Treatment options for cartilage injuries include conservative treatment, debridement restoration techniques such as microfracture and marrow stimulation technique, osteochondral autologous transplantation, and autologous chondrocyte implantation. OCD can be managed conservatively with limited weight bearing in juvenile OCD with open physis of up to 50% of patients showing full healing at 18 months. Unstable lesions can be further managed with reparative measures paired with drilling to improve subchondral blood supply.