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Online ISSN 1827-1707
Petrera M., Dwyer T., Ogilvie-Harris D. J., Theodoropoulos J. S.
University of Toronto Orthopedic Sports Medicine Women’s College Hospital, Toronto, Canada
Articular cartilage injuries of the knee are frequently observed in athletes. This may be related to the increased sport participation seen in recreational athletes, and to the increased number of training sessions and games played annually by professional athletes. These injuries limit the ability to play and in some instances can have career ending potential. In this article the authors present an overview of the currently available techniques for cartilage repair, focusing on studies reporting the outcomes of the treatment of knee cartilage lesions in athletes. Several surgical techniques are nowadays available with the aim of restoring function, allowing a return to sports at pre-injury level, while retarding the progression of isolated cartilage injuries toward osteoarthritis (OA). It has been shown that most of these techniques lead to improved and durable clinical outcomes, but there is still no gold standard treatment. Despite the paucity of randomized clinical trials, there is evidence that osteochondral autograft and articular cartilage injuries ensure a higher rate of return to the preinjury sport level. On the other hand, microfracture and osteochondral autograft allow a faster return to sport. Interestingly, while the results of osteochondral autograft tend to improve over 1 to 3 years, the outcomes of microfracture tend to deteriorate over time. The authors also identified several factors affecting the outcomes. Age, preoperative level of sport participation, duration of symptoms before surgery, location and size of the defects, and previous surgery are factors able to influence the functional scores and the rate of return to sports.