Surgical implants and technologies for cartilage repair and preservation of the knee

Focal lesions of the articular cartilage of the knee can be managed with a variety of products and technologies in an attempt to restore function to the afflicted joint and forestall the need for possible total knee arthroplasty. Among these approaches are non-implant-based procedures (arthroscopic chondroplasty and microfracture), grafting procedures (autografts/mosaicplasty and allografts), cell-based procedures (autologous chondrocyte implantation) and nonbiologic implants (metallic plugs and cell-free polymers). For each clinically established procedure there are also a number of investigational variations that aim to improve the in vivo quality of the regenerated/restored cartilage surface. This article analyzes existing and developing non-implant- and graft-based technologies for the repair or restoration of the articular cartilage of the knee based on a review of the published literature.