Treating articular cartilage injuries of the knee in young people.

Cite this as: BMJ 2010;340:c998 doi: 10.1136/bmj.c998 Articular chondral and osteochondral injuries of the knee are common in people aged under 35 years, and sympto­ matic lesions left untreated may lead to chronic pain and disability. Patients with articular chondral injuries often have a poorer function score than those awaiting surgery for other knee disorders, such as osteoarthritis or a rup­ tured anterior cruciate ligament. Patients with articular cartilage injuries may go on to develop early onset osteo­ arthritis with long term morbidity and consequent high use of health service resources; successful early treatment of these lesions would probably be cost effective. Chondral and osteochondral lesions may not be diag­ nosed or may present late because patients will often give a history of an apparent insignificant trauma and doc­ tors may fail to understand the importance of an effusion in the knee joint, which always indicates joint disease. Radiographs of the knee may be poorly interpreted. This review discusses the diagnosis and management (con­ servative and surgical) of injuries to the articular cartilage of the knee and draws on published research articles and the authors’ own experience.