TY - JOUR
T1 - The subchondral bone in articular cartilage repair
T2 - Current problems in the surgical management
AU - Gomoll, Andreas H.
AU - Madry, Henning
AU - Knutsen, Gunnar
AU - van Dijk, Niek
AU - Seil, Romain
AU - Brittberg, Mats
AU - Kon, Elizaveta
N1 - Funding Information:
Acknowledgments We thank Elke Dooley for help with the manuscript preparation. Supported in part by the Deutsche Forschungs-gemeinschaft (DFG) and the Fonds National de la Recherche (FNR).
PY - 2010/4
Y1 - 2010/4
N2 - As the understanding of interactions between articular cartilage and subchondral bone continues to evolve, increased attention is being directed at treatment options for the entire osteochondral unit, rather than focusing on the articular surface only. It is becoming apparent that without support from an intact subchondral bed, any treatment of the surface chondral lesion is likely to fail. This article reviews issues affecting the entire osteochondral unit, such as subchondral changes after marrow-stimulation techniques and meniscectomy or large osteochondral defects created by prosthetic resurfacing techniques. Also discussed are surgical techniques designed to address these issues, including the use of osteochondral allografts, autologous bone grafting, next generation cell-based implants, as well as strategies after failed subchondral repair and problems specific to the ankle joint. Lastly, since this area remains in constant evolution, the requirements for prospective studies needed to evaluate these emerging technologies will be reviewed.
AB - As the understanding of interactions between articular cartilage and subchondral bone continues to evolve, increased attention is being directed at treatment options for the entire osteochondral unit, rather than focusing on the articular surface only. It is becoming apparent that without support from an intact subchondral bed, any treatment of the surface chondral lesion is likely to fail. This article reviews issues affecting the entire osteochondral unit, such as subchondral changes after marrow-stimulation techniques and meniscectomy or large osteochondral defects created by prosthetic resurfacing techniques. Also discussed are surgical techniques designed to address these issues, including the use of osteochondral allografts, autologous bone grafting, next generation cell-based implants, as well as strategies after failed subchondral repair and problems specific to the ankle joint. Lastly, since this area remains in constant evolution, the requirements for prospective studies needed to evaluate these emerging technologies will be reviewed.
KW - Autologous chondrocyte implantation
KW - Cartilage repair
KW - Microfracture
KW - Subchondral bone
UR - http://www.scopus.com/inward/record.url?scp=77951253755&partnerID=8YFLogxK
U2 - 10.1007/s00167-010-1072-x
DO - 10.1007/s00167-010-1072-x
M3 - Article
C2 - 20130833
AN - SCOPUS:77951253755
SN - 0942-2056
VL - 18
SP - 434
EP - 447
JO - Knee Surgery, Sports Traumatology, Arthroscopy
JF - Knee Surgery, Sports Traumatology, Arthroscopy
IS - 4
ER -