Cartilage defects that penetrate the subchondral bone can undergo spontaneous repair through the formation of a fibrous or cartilaginous tissue mediated primarily by mesenchymal stem cells from the bone marrow. This tissue is biomechanically inferior to normal articular cartilage, and is often observed to degrade over time. The factors that control the type and quality of the repair tissue, and...

J Bone Joint Surg [Br] 2009;91-B:997-1006. Chondral damage to the knee is common and, if left untreated, can proceed to degenerative osteoarthritis. In symptomatic patients established methods of management rely on the formation of fibrocartilage which has poor resistance to shear forces. The formation of hyaline or hyaline-like cartilage may be induced by implanting autologous, cultured chondr...

The treatment of osteochondral lesions of the talus has evolved with the development of improved imaging and arthroscopic techniques. However, the outcome of treatment for large cystic type-V lesions is poor, using conventional grafting, debridement or microfracture techniques. This retrospective study examined the outcomes of 50 patients with a cystic talar defect who were treated with arthros...

Osteochondral lesions are drilled with the aim of stimulating the growth of new cartilage to cover the defect (Pnidie 1959). This may be performed at arthrotomy or anthroscopically, but arthroscopic drilling is far from standard practice. Performed percutaneously, arthroscopic drilling by Kirschner wire can be hindered by difficulty with accurate placement, skidding off sclerotic bone and entan...