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J Knee Surg 2023; 36(04): 368-381
DOI: 10.1055/s-0041-1735278
Original Article

The Large Focal Isolated Chondral Lesion

Jorge Chahla
1   Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
,
Brady T. Williams
2   Department of Orthopedic Surgery, University of Colorado, Aurora, Colorado
,
Adam B. Yanke
1   Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
,
Jack Farr
3   Knee Preservation and Cartilage Restoration Center, OrthoIndy, Indianapolis, Indiana
› Author Affiliations Funding None.
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Abstract

Focal chondral defects (FCDs) of the knee can be a debilitating condition that can clinically translate into pain and dysfunction in young patients with high activity demands. Both the understanding of the etiology of FCDs and the surgical management of these chondral defects has exponentially grown in recent years. This is reflected by the number of surgical procedures performed for FCDs, which is now approximately 200,000 annually. This fact is also apparent in the wide variety of available surgical approaches to FCDs. Although simple arthroscopic debridement or microfracture are usually the first line of treatment for smaller lesions, chondral lesions that involve a larger area or depth require restorative procedures such as osteochondral allograft transplantation or other cell-based techniques. Given the prevalence of FCDs and the increased attention on treating these lesions, a comprehensive understanding of management from diagnosis to rehabilitation is imperative for the treating surgeon. This narrative review aims to describe current concepts in the treatment of large FCDs through providing an algorithmic approach to selecting interventions to address these lesions as well as the reported outcomes in the literature.

Keywords

cartilage - focal chondral defect - osteochondral - knee - regenerative


Publication History

Received: 27 December 2019

Accepted: 25 June 2020

Article published online:
10 September 2021

© 2021. Thieme. All rights reserved.

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333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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