Surgical treatment options for weight bearing articular surface defect

Treatment of full thickness defects of weight bearing articular surfaces is one of the most challenging problem of the daily orthopaedic practice. Recently published statistical evaluations of different arthroscopic findings support that 80% of full thickness defects of weight bearing areas leads to early osteoarthritis in a 5-10 years period. Beside traditional resurfacing procedures in the last two decades several new techniques have been developed to promote a hyaline or hyaline-like repair of the defected area. Basic science data, experimental results and preclinical evaluations supported wide clinical use of microfracture technique and autologous osteochondral mosaicplasty. Insurance company data confirm that yearly more, than 200 000 resurfacing procedures are performed according to the above mentioned two techniques all over the world. Beside these two popular resurfacing options autologous chondrocyte implantation may be a promising future alternative to treat extended defect areas. Beside basic science information and experimental data clinical experiences of more, than 8000 human implantations support such an application of cell therapy. This paper gives an outline of actual clinical resurfacing options and summarizes recent advances of cartilage repair.