Abstract
Focal chondral defects (FCDs) of the knee can be a debilitating condition that can
clinically translate into pain and dysfunction in young patients with high activity
demands. Both the understanding of the etiology of FCDs and the surgical management
of these chondral defects has exponentially grown in recent years. This is reflected
by the number of surgical procedures performed for FCDs, which is now approximately
200,000 annually. This fact is also apparent in the wide variety of available surgical
approaches to FCDs. Although simple arthroscopic debridement or microfracture are
usually the first line of treatment for smaller lesions, chondral lesions that involve
a larger area or depth require restorative procedures such as osteochondral allograft
transplantation or other cell-based techniques. Given the prevalence of FCDs and the
increased attention on treating these lesions, a comprehensive understanding of management
from diagnosis to rehabilitation is imperative for the treating surgeon. This narrative
review aims to describe current concepts in the treatment of large FCDs through providing
an algorithmic approach to selecting interventions to address these lesions as well
as the reported outcomes in the literature.
Keywords
cartilage - focal chondral defect - osteochondral - knee - regenerative
