Current concepts in articular cartilage repair

Our knowledge of articular cartilage pathophysiology has advanced hugely in the last 20 years. Although once thought of as a structure incapable of intrinsic repair, we now have a selection of treatment options available in clinical practice, which we can use to attempt to reproduce the specific zonal architecture and mechanical composition of hyaline cartilage. This review will focus on the structure and function of articular cartilage, the aetiology of cartilage injury, and how the disease process can be investigated and treated. Different treatment options will be described providing an up to date review of the spectrum of treatment modalities, from the simple marrow stimulation techniques, to osteochondral transfer, chondrocyte transplantation and finally tissue engineering. Each will be illustrated with examples from the literature, providing a current concepts review on the outcomes following these repair strategies.