Table 1.

The current approaches used in the treatment of cartilage and osteochondral defects.

Method	Notes
Lavage/arthroscopic cleaning with NaCl/Ringer’s solution	Alleviate pain. The effects are only temporary. No healing achieved in later stages.
Debridement5	Symptomatic relief. Not stimulate chondrogenesis or repair.
Abrasion arthroplasty and drilling6,7	Achieve formation of fibrous, hyaline-like cartilage. Drilling is more effective. No full healing.
Osteotomy8	Involves the manual realignment of cartilage surface by interrupting the bone at a distance from the cartilage lesions.
Total knee replacement procedures9	Performed in more aged patients as the life time of the prosthetics is limited by its loosening with time, and a significant amount of bone loss and pain is associated with prosthetic joints.
Microfracture10	Involves the stimulation of repair using microfractures through which the bone marrow is drawn from the subchondral bone. The fibrous and mechanically weak tissue which forms in this way provides only a temporary solution.
Autologous chondrocyte transplantation (ACT)11	Approximately 10–12 million cells can be implanted into a 10-cm2 defect area. Rehabilitation in the postoperative period is of importance. Complications include the postoperative problems that may form with arthrotomy, the inability to successfully suture periosteal tissue to defect sites, and the delayed hypertrophic response of the body.
Osteochondral transplantation or mosaicplasty12,13	Involves transplanting healthy tissues containing the required cells from a donor site to areas where they are needed. Disadvantages include donor site morbidity, abrasion against surfaces opposite to the graft, and damage to chondrocytes within donor and recipient regions.
Scaffolds/matrices (polymeric or composite), MACI14	Cells proliferated on the matrix and then this structure is delivered to the defect site. Disadvantages include the loss of phenotypic features of chondrocytes and the inability to homogeneously distribute these cells.
Stem cells delivered within 3D matrices	The key criteria include biocompatibility, porosity, biodegradability, and the ability to prevent phenotypic losses in cells and enabling their uniform distribution. Poor cell distribution and mechanical strength are the two main limiting factors for the uptake of such matrices.

MACI: matrix-assisted chondrocyte implantation; 3D: three-dimensional.