Skip to main content
SpringerLink
Log in

Articular Cartilage Repair of the Knee in Athletes

  • Chapter
  • First Online:
Developing Insights in Cartilage Repair

Abstract

Athletes are at an elevated risk for articular cartilage injury of the knee, especially in pivoting sports such as soccer and basketball. Due to the poor intrinsic healing response of articular cartilage, these injuries can be debilitating and even career threatening for high level athletes. Athletes often damage their articular cartilage in conjunction with other pathology such as an anterior cruciate ligament tear or meniscus tear, and these typically need to be addressed at the same time as the articular cartilage. Fortunately, there are an increasing number of surgical treatment options available to restore the articular cartilage of the knee. Outcomes data is still relatively limited, especially for athletes, but there is a growing body of evidence that patients can return to sport after articular cartilage surgery, although the recovery may be lengthy. Microfracture and autologous chondrocyte implantation, and osteochondral autograft to a lesser degree, have demonstrated fair to good rates of return to sport. Appropriate rehabilitation is essential and the quality of the tissue repair appears to be an important factor influencing return to play. Much of the evidence for return to play is in soccer and American football, with less data for other sports. Although promising, more studies are needed to better define and predict return to play and long term outcomes in athletes after articular cartilage surgery in the knee.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Drawer S, Fuller CW. Propensity for osteoarthritis and lower limb joint pain in retired professional soccer players. Br J Sports Med. 2001;35(6):402–8.

    Article  PubMed  CAS  Google Scholar 

  2. Kujala UM, Kettunen J, Paananen H, Aalto T, Battie MC, Impivaara O, et al. Knee osteoarthritis in former runners, soccer players, weight lifters, and shooters. Arthritis Rheum. 1995;38(4):539–46.

    Article  PubMed  CAS  Google Scholar 

  3. Mandelbaum BR, Browne JE, Fu F, Micheli L, Mosely Jr JB, Erggelet C, et al. Articular cartilage lesions of the knee. Am J Sports Med. 1998;26(6):853–61.

    PubMed  CAS  Google Scholar 

  4. Flanigan DC, Harris JD, Trinh TQ, Siston RA, Brophy RH. Prevalence of chondral defects in athletes’ knees: a systematic review. Med Sci Sports Exerc. 2010;42(10):1795–801.

    Article  PubMed  Google Scholar 

  5. Nepple JJ, Wright RW, Matava MJ, Brophy RH. Full-thickness knee articular cartilage defects in national football league combine athletes undergoing magnetic resonance imaging: prevalence, location, and association with previous surgery. Arthroscopy. 2012;28(6):798–806.

    Article  PubMed  Google Scholar 

  6. Hirshorn KC, Cates T, Gillogly S. Magnetic resonance imaging-documented chondral injuries about the knee in college football players: 3-year National Football League Combine data. Arthroscopy. 2010;26(9):1237–40.

    Article  PubMed  Google Scholar 

  7. Major NM, Helms CA. MR imaging of the knee: findings in asymptomatic collegiate basketball players. AJR Am J Roentgenol. 2002;179(3):641–4.

    Article  PubMed  Google Scholar 

  8. Kaplan LD, Schurhoff MR, Selesnick H, Thorpe M, Uribe JW. Magnetic resonance imaging of the knee in asymptomatic professional basketball players. Arthroscopy. 2005;21(5):557–61.

    Article  PubMed  Google Scholar 

  9. Walczak BE, McCulloch PC, Kang RW, Zelazny A, Tedeschi F, Cole BJ. Abnormal findings on knee magnetic resonance imaging in asymptomatic NBA players. J Knee Surg. 2008;21(1):27–33.

    PubMed  Google Scholar 

  10. Schueller-Weidekamm C, Schueller G, Uffmann M, Bader TR. Does marathon running cause acute lesions of the knee? Evaluation with magnetic resonance imaging. Eur Radiol. 2006;16(10):2179–85.

    Article  PubMed  CAS  Google Scholar 

  11. Krampla W, Mayrhofer R, Malcher J, Kristen KH, Urban M, Hruby W. MR imaging of the knee in marathon runners before and after competition. Skeletal Radiol. 2001;30(2):72–6.

    Article  PubMed  CAS  Google Scholar 

  12. Harris JD, Brophy RH, Siston RA, Flanigan DC. Treatment of chondral defects in the athlete’s knee. Arthroscopy. 2010;26(6):841–52.

    Article  PubMed  Google Scholar 

  13. Mithoefer K, Hambly K, Della Villa S, Silvers H, Mandelbaum BR. Return to sports participation after articular cartilage repair in the knee: scientific evidence. Am J Sports Med. 2009;37 Suppl 1:167S–76.

    Article  PubMed  Google Scholar 

  14. Steadman JR, Rodkey WG, Rodrigo JJ. Microfracture: surgical technique and rehabilitation to treat chondral defects. Clin Orthop Relat Res. 2001;(391 Suppl):S362–9.

    Google Scholar 

  15. Cerynik DL, Lewullis GE, Joves BC, Palmer MP, Tom JA. Outcomes of microfracture in professional basketball players. Knee Surg Sports Traumatol Arthrosc. 2009;17(9):1135–9.

    Article  PubMed  Google Scholar 

  16. Namdari S, Baldwin K, Anakwenze O, Park MJ, Huffman GR, Sennett BJ. Results and performance after microfracture in National Basketball Association athletes. Am J Sports Med. 2009;37(5):943–8.

    Article  PubMed  Google Scholar 

  17. Blevins FT, Steadman JR, Rodrigo JJ, Silliman J. Treatment of articular cartilage defects in athletes: an analysis of functional outcome and lesion appearance. Orthopedics. 1998;21(7):761–7; discussion 7–8.

    PubMed  CAS  Google Scholar 

  18. Mithoefer K, Williams 3rd RJ, Warren RF, Wickiewicz TL, Marx RG. High-impact athletics after knee articular cartilage repair: a prospective evaluation of the microfracture technique. Am J Sports Med. 2006;34(9):1413–8.

    Article  PubMed  Google Scholar 

  19. Kreuz PC, Steinwachs M, Erggelet C, Lahm A, Krause S, Ossendorf C, et al. Importance of sports in cartilage regeneration after autologous chondrocyte implantation: a prospective study with a 3-year follow-up. Am J Sports Med. 2007;35(8):1261–8.

    Article  PubMed  Google Scholar 

  20. Mithofer K, Peterson L, Mandelbaum BR, Minas T. Articular cartilage repair in soccer players with autologous chondrocyte transplantation: functional outcome and return to competition. Am J Sports Med. 2005;33(11):1639–46.

    Article  PubMed  Google Scholar 

  21. Mithofer K, Minas T, Peterson L, Yeon H, Micheli LJ. Functional outcome of knee articular cartilage repair in adolescent athletes. Am J Sports Med. 2005;33(8):1147–53.

    Article  PubMed  Google Scholar 

  22. Kish G, Modis L, Hangody L. Osteochondral mosaicplasty for the treatment of focal chondral and osteochondral lesions of the knee and talus in the athlete. Rationale, indications, techniques, and results. Clin Sports Med. 1999;18(1):45–66, Vi.

    Article  PubMed  CAS  Google Scholar 

  23. Hangody L, Dobos J, Balo E, Panics G, Hangody LR, Berkes I. Clinical experiences with autologous osteochondral mosaicplasty in an athletic population: a 17-year prospective multicenter study. Am J Sports Med. 2010;38(6):1125–33.

    Article  PubMed  Google Scholar 

  24. Krych AJ, Robertson CM, Williams 3rd RJ. Return to athletic activity after osteochondral allograft transplantation in the knee. Am J Sports Med. 2012;40(5):1053–9.

    Article  PubMed  Google Scholar 

  25. Gudas R, Stankevicius E, Monastyreckiene E, Pranys D, Kalesinskas RJ. Osteochondral autologous transplantation versus microfracture for the treatment of articular cartilage defects in the knee joint in athletes. Knee Surg Sports Traumatol Arthrosc. 2006;14(9):834–42.

    Article  PubMed  Google Scholar 

  26. Kon E, Filardo G, Berruto M, Benazzo F, Zanon G, Della Villa S, et al. Articular cartilage treatment in high-level male soccer players: a prospective comparative study of arthroscopic second-generation autologous chondrocyte implantation versus microfracture. Am J Sports Med. 2011;39(12):2549–57.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Washington University School of Medicine, 14532 South Outer Forty Drive, Chesterfield, MO, 63017, USA

    Robert H. Brophy MD

Authors
  1. Robert H. Brophy MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert H. Brophy MD .

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands

    Pieter J. Emans

  2. Department of Orthopedics, University of Gothenburg, Gothenburg, Sweden

    Lars Peterson

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Brophy, R.H. (2014). Articular Cartilage Repair of the Knee in Athletes. In: Emans, P., Peterson, L. (eds) Developing Insights in Cartilage Repair. Springer, London. https://doi.org/10.1007/978-1-4471-5385-6_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-5385-6_14

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5384-9

  • Online ISBN: 978-1-4471-5385-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation