Cartilage repair

Last revised by Joachim Feger on 10 Dec 2021

Citation, DOI, disclosures and article data

Citation:

Feger J, Foster T, Cartilage repair. Reference article, Radiopaedia.org (Accessed on 08 May 2024) https://doi.org/10.53347/rID-81823

DOI:

https://doi.org/10.53347/rID-81823

Permalink:

https://radiopaedia.org/articles/81823

rID:

81823

Article created:

3 Sep 2020, Joachim Feger ◉

Disclosures:

At the time the article was created Joachim Feger had no recorded disclosures.

View Joachim Feger's current disclosures

Last revised:

10 Dec 2021, Joachim Feger ◉

Disclosures:

At the time the article was last revised Joachim Feger had no recorded disclosures.

View Joachim Feger's current disclosures

Revisions:

4 times, by 2 contributors - see full revision history and disclosures

Systems:

Musculoskeletal

Tags:

cases3, figures, cartilage

Synonyms:

Cartilage reconstruction
MOCART

Cartilage repair and reconstruction comprises different surgical methods for the restoration of the chondral surface within different diarthrodial joints, with the goal to promote cartilage healing, alleviate patient symptoms as well as enable them to return to daily activities and sports and prevent or delay the onset of osteoarthritis.

It can be subdivided into different methods ^1,2.

bone marrow stimulation
- abrasion arthroplasty
- subchondral drilling
- microfracture
tissue-based therapies
- osteochondral autograft transplantation
- osteochondral allograft transplantation
- engineered scaffold implantation
cell-based therapies
- autologous chondrocyte implantation
- matrix-induced chondrocyte implantation
other techniques:
- direct fixation with biodegradable pins or bioabsorbable screws

Treatment decisions and choice of method will depend on several different factors including the following ¹:

location of the lesion
size of the defect
involvement of the subchondral bone
age and activity level of the patient
willingness to participate in rehabilitation

Radiographic features

Postoperative results and complications of cartilage repair and reconstruction can be morphologically evaluated with the MRI observation of cartilage repair tissue (MOCART) scoring system ^3,4. It comprises the following 11 structural variables for the assessment ^3,4:

defect filling: different degrees compared to the adjacent articular cartilage
chondral interface: intact, visible border, visible defect <50%, visible defect >50%
bony interface: intact, partial/complete delamination
articular surface: intact, defect <50%, defect >50%, adhesion
repair tissue structure: homogeneous, inhomogeneous or cleft
repair tissue signal intensity: normal, near-normal, abnormal
subchondral bone plate: intact, breach
chondral osteophytes: absent, <50%, >50% of repair tissue
subchondral bone marrow edema: absent small (<1 cm), moderate (<2 cm), large (<4 cm), diffuse
subchondral bone: intact, granulation tissue, cysts
joint effusion: absent small, moderate, large