Tratamiento de defectos del cartílago de la rodilla

Focal cartilage lesions of the knee joint frequently cause chronic symptoms and therefore require early treatment. Concomitant pathologies such as malalignment, ligamentous instability, or meniscal deficiency have a decisive impact on the outcome of cartilage regenerative procedures and must therefore be addressed concomitantly. Small chondral defects up to approximately 2 cm² are commonly treated primarily by bone marrow stimulation (BMS), preferably using microdrilling techniques. For defects of approximately 1-4 cm², matrix-augmented bone marrow stimulation (m-BMS) is considered the standard of care, providing superior mid-term outcomes. Larger defects exceeding approximately 2 cm² are preferentially treated with matrix-associated autologous chondrocyte transplantation (m-ACT), which has demonstrated stable long-term results. Osteochondral lesions require a combined treatment approach addressing both cartilage and subchondral bone. Overall, treatment follows a clearly defined stepwise concept based on epidemiological factors, defect morphology, concomitant pathologies, and structured rehabilitation.