[Therapy of articular cartilage lesions]

Lesions of adult articular cartilage do not heal or regenerate. They give rise to the development of osteoarthritis, and surgical treatment is necessary before the initiation of joint degeneration. Various treatment modalities ranging from microfracture to autologous mosaicplasty and autologous chondrocyte transplantation are available. Commonly they are distinguished by the presence or absence of cell transplantation. The treatment choice depends on size, depth, and location of the lesion; therefore exact classification is mandatory. The surgical procedure aims to reconstruct a physiological distribution of the biomechanical forces by surface restoration. Additional joint pathologies such as mechanical axis deviation, meniscal defects, and ligament insufficiencies threaten the surgical success and must be addressed simultaneously.