Cartilage repair

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Cartilage repair and reconstruction comprises different surgical methods for the restoration of the chondral surface within different diarthrodial joints, with the goal to promote cartilage healing, to alleviate patient symptoms as well as to enable them to return to daily activities and sports and to prevent or delay the onset of osteoarthritis.

It can be subdivided into different methods .

Treatment decisions and choice of method will depend on a number of different factors including the following :

  • location of the lesion
  • size of the defect
  • involvement of the subchondral bone
  • age and activity level of the patient
  • willingness to participate in rehabilitation

Radiographic features

Postoperative results and complications of cartilage repair and reconstruction can be morphologically evaluated with the MRI observation of cartilage repair tissue (MOCART) scoring system . It comprises the following 11 structural variables for the assessment :

  • defect filling: different degrees in relation to the adjacent cartilage
  • chondral interface: intact, visible border, visible defect <50%, visible defect >50%
  • bony interface: intact, partial/complete delamination
  • articular surface: intact, defect <50%, defect >50%, adhesion
  • repair tissue structure: homogeneous, inhomogeneous or cleft
  • repair tissue signal intensity: normal, near-normal, abnormal
  • subchondral bone plate: intact, breach
  • chondral osteophytes: absent, <50%, >50% of repair tissue
  • subchondral bone marrow edema: absent small (<1cm), moderate (<2cm), large (<4cm), diffuse
  • subchondral bone: intact, granulation tissue, cysts
  • joint effusion: absent small, moderate, large