[Lesions of articular cartilage and their treatment]

Lesions of human articular cartilage most often are the result of a pathogenetically unclear disease process eventually leading to primary osteoarthrosis. The increasing incidence of traumatic injuries during sport activities, leading to lesions of cartilage and bone, is also worth noting. In addition, osteochondrosis dissecans and hereditary dysplasias of the skeletal system may lead to osseous and cartilaginous lesions. Adult articular cartilage has only very limited repair capacity in response to acute and chronic insults. Even now, diagnostic tools and methods of diagnosing cartilaginous lesions are still far from accurate. Lesions seen by conventional imaging technology chiefly represent late and irreversible damage of joint cartilage structures. The present review first summarizes current basic knowledge of joint anatomy and physiology, to enable the reader to understand better the unique nature of cartilaginous lesions and the difficulties and controversies involved in old and novel experimental methodologies in cartilage repair. It then critically evaluates developments in orthopedic therapy for repair of articular cartilage lesions.