The Science of Illustrated Cartilage Repair and Its Rationale

A historic statement by Hunter [1], “Ulcerated cartilage is a troublesome thing, once destroyed…. is not repaired” had a great impact on the attempts of cartilage repair for almost 250 years. The observation came when he was studying inflammation, suppuration, or lymph collection around a wound and found none appearing around the cartilage and the corneal lesions. Though true in a research context, the statement was not true in the context of a surgical intervention. Hunter brother’s findings were questioned by many authors [2–4], but still, no attempts were made to repair the cartilage until the latter half of the last century [5]. Cartilage repair is presently a fast-changing science with a very fast evolution process. The last two decades have seen a plethora of surgical techniques and products that can keep even a veteran cartilage surgeon guessing. Many products have come and have vanished. There are huge controversies and concurrences for each and every cartilage repair technique; be it a marrow stimulation technique, an osteochondral cylinder transfer technique, a cell-based technique or a scaffold-based technique. But then, every change in the technique is making us more equipped to better understand the science behind the cartilage repair. Young surgeons are very keen to learn and understand this emerging field of cartilage repair. However, as the cartilage science is yet to reach a consensus plateau, they are unable to have a clear and a long-lasting message about the cartilage repair. Diversities of the opinions also make it nearly impossible for young surgeons to have a first-hand experience of all the existing technologies.