Table 3.

Overview of Cartilage Repair Techniques.

Technique	Indications
Marrow stimulation/microfracture	Patients younger than 55 years; focal contained defect (surrounded by intact cartilage); no subchondral bone involvement; femoral condyles; smaller lesions of 2 cm2 or less have better outcome than larger lesions
Osteochondral autograft transplantation	Active patients younger than 50 years; smaller lesions of 2.5 cm2 or less; subchondral bone involvement; better rates of return to sports versus microfracture
Osteochondral allograft transplantation	Lesions with bone and cartilage loss; large, uncontained lesions (i.e., extending beyond the margin or the cartilage or deep into subchondral bone); lesions between 2 and 4 cm2 in diameter; particularly useful for revision of previously performed cartilage repair procedures, especially when the subchondral bone is damaged; needs fresh matched donor; expensive
Particulate cartilage allograft	Focal articular cartilage defects; contained lesions; lesions size <3 cm2
Autologous chondrocyte transplantation	Large, full-thickness traumatic defects in patients between ages of 15 and 40 years; must have preserved subchondral bone with no involvement; requires two operations; outcome is mixed
Open reduction and internal fixation of a large osteochondral lesion (OCD)	Large traumatic defects or displaced OCD with preserved cartilage; acute injuries; fragment must be big enough to hold screws for fixation
Femoral condyle transplantation	Large area of avascular necrosis of the femur in younger patients; can be considered in extreme cases in young patients trying to avoid total knee replacement as a salvage procedure