Considerations prior to surgical repair of articular cartilage injuries of the knee

The diagnosis and treatment of articular cartilage injuries of the knee has gained increased attention in recent years. With the advancement of surgical techniques such as autologous cultured chondrocyte implantation and osteochondral plug transfer to repair the chondral defects, a more aggressive treatment approach has also been adopted. Inititiating a treatment for an articular cartilage defect, it is imperative to have a complete assessment of any nonstructural or structural abnormalities that may have contributed to the development of the defect. Nonstructural factors include genetic factors; metabolic, inflammatory, or developmental diseases; activity level; and body weight. Structural factors include malalignment and ligamentous and meniscal deficiencies. The failure to recognize and correct these abnormalities when possible causes the degeneration and eventual failure of the articular cartilage repair regardless of the surgical technique used.