A military perspective to articular cartilage defects

Articular cartilage injuries present a challenge in terms of definitive treatment in the United States military population. Active duty soldiers' physical demands are unlike the general population in that a military career requires soldiers to maintain a physical activity level similar to that of an athletic population. Current treatment options for the chondral defect include microfracture, osteochondral transplantation, and autologous chondrocyte implantation. These treatment modalities carry specific advantages and disadvantages and must be considered when evaluating and treating patients with chondral injuries. It is unclear which procedure is the best first-line treatment for these injuries, but newer studies are beginning to evaluate these procedures over time and in high demand populations. The purpose of this article is to review current treatment options as they relate to return to full activity of the young "combat athlete." Results of each treatment option from published data will be compared and reviewed throughout this article.