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    Interventional procedure overview of single-step scaffold insertion for repairing symptomatic chondral knee defects

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    Indications and current treatment

    Chondral cartilage is the material that covers the end of the bones in the knee joint, to protect them from friction when moving. Damage to this cartilage (chondral knee defect) can cause symptoms such as knee pain and stiffness, and reduced mobility. Untreated full-thickness cartilage lesions may be associated with significant pain and, eventually, arthritis. This is a major cause of disability.

    There are several approaches to managing chondral knee defects. Surgical options depend on the characteristics of the person and the defect. There are 2 main categories of procedure:

    • Procedures that mainly aim for symptom relief include:

      • debridement

      • osteotomy

      • knee replacement.

    • Procedures that aim for symptom relief and also to re-establish the cartilage surface include:

      • marrow stimulation techniques (such as Pridie drilling and microfracture)

      • mosaicplasty

      • OAT

      • focal articular resurfacing implants

      • ACI (in which chondrocytes harvested from the knee are cultured and implanted into the damaged cartilage).

    Sometimes mACI is done. This is a 2-step procedure because cells have to be cultured outside the body. The cells are harvested for culturing in the first operation, then the cultured cells and scaffold are introduced in the second.