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Surgical Approach to Articular Cartilage Repair

  • Jaskarndip Chahal
  • Benedict A. Rogers
  • Allan E. GrossEmail author
Chapter
  • 66 Downloads

Abstract

This chapter provides a comprehensive approach to evaluating patients with articular cartilage defects, as well as a description of treatment algorithms and surgical techniques. During the initial workup (history, physical exam, imaging), a thorough lower extremity assessment is emphasized such that comorbidities including ligamentous instability, malalignment, and meniscal deficiency can be concomitantly addressed. Patient and defect-specific factors pertinent to surgical decision-making are discussed along with an evidence-based and technical overview of common surgical approaches including microfracture, osteochondral (OC) autograft/allograft, and autologous chondrocyte implantation (ACI). An approach to patients with a failed index cartilage procedure is also described.

Keywords

Osteochondral allograft Osteochondral autograft Autologous chondrocyte implantation Microfracture Treatment algorithm Revision surgery Comorbidities 

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  • Jaskarndip Chahal
    • 1
    • 2
    • 3
  • Benedict A. Rogers
    • 4
    • 5
  • Allan E. Gross
    • 6
    • 7
    Email author
  1. 1.Division of Orthopaedic SurgeryUniversity of TorontoTorontoCanada
  2. 2.University of Toronto Orthopaedic Sports Medicine and University Health Network Arthritis ProgramTorontoCanada
  3. 3.Division of Orthopaedic SurgeryToronto Western Hospital and Women’s College HospitalTorontoCanada
  4. 4.Brighton and Sussex Medical SchoolBrightonUK
  5. 5.Trauma and Orthopaedics DepartmentBrighton and Sussex University Hospitals NHS TrustBrightonUK
  6. 6.Division of Orthopaedic SurgeryUniversity of TorontoTorontoCanada
  7. 7.Gluskin Granovsky Division of OrthopaedicsJoseph and Wolf Lebovic Health Complex, Mount Sinai HospitalTorontoCanada

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