Theoretically, articular cartilage restoration should be a solvable biological/mechanical problem. But repairing, restoring, or replacing hyaline cartilage and the matrix that supports it presents formidable physiological and physical challenges. For decades, researchers have been investigating many different methods of cartilage repair, and no approach has yet risen to “gold standard” status.
As the “Current Concepts Review” in the February 19, 2014, edition of JBJS points out, the main strategy for cartilage “self-repair” is bone marrow stimulation, primarily via microfracture. Restorative/replacement approaches focus on cartilaginous constructs composed of allogenic, autogenic, or tissue-engineered materials.