Cartilage Repair Strategies in Athletes' Knees

Athletes are prone to focal cartilage defects in the knee that, if untreated, may lead to pain, dysfunction and early osteoarthritis. Articular cartilage has limited intrinsic healing capacity owing to its avascular and aneural nature, motivating the development of surgical and biological repair techniques. Established surgical approaches include microfracture, which induces marrow-derived repair tissue; osteochondral autograft transplantation, in which healthy cartilage–bone plugs are moved to the defect site; and autologous chondrocyte implantation, whereby patient-derived cartilage cells are expanded and re-implanted under a periosteal or synthetic membrane. More recent strategies combine scaffolds of hyaluronic acid or collagen with mesenchymal stem cells or growth factors to promote hyaline-like cartilage formation. Biological adjuvants such as platelet-rich plasma or bone morphogenetic proteins have been incorporated to enhance repair tissue quality and accelerate rehabilitation. Rehabilitation protocols have evolved towards early mobilisation and controlled load-bearing to stimulate matrix maturation while protecting the repair. The global impact of these innovations lies in shortening time to return to sport, improving long-term joint health and reducing the socioeconomic burden of sports-related knee injuries.

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Cartilage Repair Strategies in Athletes' Knees publication trend

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Technical terms

Microfracture: A surgical technique that creates small holes in subchondral bone to release marrow-derived stem cells and promote formation of repair tissue.

Hyaluronic acid scaffold: A biodegradable matrix composed of hyaluronic acid used to support cell attachment and cartilage regeneration.

Autologous chondrocyte implantation (ACI): A two-stage procedure in which a patient’s own cartilage cells are harvested, expanded in vitro and re-implanted into a cartilage defect beneath a covering membrane.

Osteochondral autograft transplantation (OATS): The transfer of intact cartilage–bone plugs from a non-weight-bearing area to fill a cartilage defect, restoring surface contour and subchondral support.

Platelet-rich plasma (PRP): A blood‐derived concentrate rich in growth factors used to stimulate tissue repair and modulate inflammation.

References

1. Rehabilitation of Soccer Players’ Knee Injuries: Cartilage Reconstruction, Anterior Cruciate Ligament Surgery, and Intensive Recovery—A Pilot Study. Journal of Clinical Medicine (2023).
2. Hyalofast Cartilage Repair Surgery with a Full Load-Bearing Rehabilitation Program One Day after Operation Reduces the Time for Professional Athletes to Return to Play. Medicina (2023).