Partial-Thickness Articular Cartilage Defects: Evaluation and Treatment

Existing scientific publications regarding evaluation and treatment of partial-thickness articular cartilage defects report conflicting results. Magnetic resonance imaging is an excellent diagnostic evaluation tool. In the community setting, however, using magnetic resonance imaging to evaluate partial-thickness cartilage defects may have variable or low sensitivity and specificity. Today, diagnostic arthroscopy with visual inspection and probing of the entire articular surface may be the gold standard for diagnostic evaluation of partial-thickness cartilage lesions. However, before surgery, nonsurgical treatment is recommended based on the presumptive diagnosis. Mechanical debridement and lavage using a suction oscillating shaver (chondroplasty) is the accepted surgical treatment of choice. However, reported outcomes of mechanical chondroplasty are not so good as might be expected, and basic and clinical research suggests that thermal chondroplasty using radiofrequency energy may prove superior in the future. In addition, basic research suggests that treatments using growth factors may, in the future, expand management options. (C) 2006 Elsevier Inc. All rights reserved.