Review of articular cartilage repair techniques and their application in the horse

Articular cartilage lesions represent a significant career-limiting problem in athletic horses. A healthy articular cartilage surface is vital for optimal joint function, and defects can result in irreversible degenerative changes. Successful treatment of cartilage lesions remains a long-standing challenge for orthopaedic surgeons, prompting ongoing research into new surgical techniques for their management. This narrative review describes surgical procedures for the treatment of cartilage/osteochondral lesions, as well as the use of the horse as a highly translational preclinical model to humans, resulting in the advancement of repair techniques for both horses and humans alike. The review encompasses both traditional techniques such as debridement and microfracture, as well as newly developed techniques and cellular therapies such as osteochondral transplantation, cell transplantation, and biologic or synthetic scaffolds. The efficacy and limitations of these approaches, as well as recent advances in the development of new biomaterials, cellular therapies, and surgical implants that are shaping the future of cartilage repair, are discussed. While there is no existing treatment that can restore normal cartilage structure and function, newly developed treatments have shown an improved quality of repair tissue experimentally. However, the translation to improved patient outcomes lags behind.