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Cartilage, a highly specialized “material”, made mainly of water, collagen, proteins and lipids, covers the ends of the bones of the joints, distributing loads, absorbing vibrations, and protecting the articular surfaces from wearing and tearing, as it minimizes friction and facilitates motion. Their thickness varies from 2 to 4 millimeters, and decreases as time passes. Given that nerves or vessels  do not penetrate them (they “feed” on the synovial fluid), they have a very limited self-healing capability.


Damages to the cartilage of the joints is actually a challenge for orthopaedists: If they are not diagnosed early, and if the injury or the condition is not treated promptly, then the whole cartilage is gradually affected, leading, first, to chondropathy and then, when complete damage has occurred and the articular surfaces remain uncovered, to osteoarthritis.
Patients usually visit the doctor with stage 3 and stage 4 lesions, which affect the normal joint function and cause pain, effusion, and noises during motion. It is most likely for them to belong to young people who practice sports - a specific or recurrent injury, or osteochondritis, may also be other causes.


Cartilage lesions are not treated conservatively. Their surgical restoration is mainly performed using arthroscopy techniques, while open techniques are only used in cases of extensive injuries. More specifically, regarding professional athletes, it is possible to arthroscopically remove a cartilaginous loose body that “disturbs” the joint, and to perform the final surgical repair of the lesion at a second stage.

Regarding lesions that occupy a small area of the cartilage, the microfracture and microdrilling techniques are selected to open “communication” channels between the injured cartilage and the subchondral bone, which is rich in mesenchymal stem cells, which are transformed into chondrocytes, when placed on the problematic surfaces. Certainly, the new cartilage tissue which is formed is of inferior quality and with a limited mechanical strength.

Alternatively, osteochondral cylindrical plugs originating from areas of the affected joint and which are not involved in its function, or synthetic grafts, are implanted. The advantage of this technique is that custom-tailored cartilage is placed, and thus, any concomitant lesion in the subchondral bone (osteonecrosis) is treated. The success rate reaches 80-90%, but a disadvantage consists in the limitation on how many cylinders can be obtained from the donor area.
In cases where lesions occupy a large area of the cartilage, or, at the same time, the subchondral bone is deeply affected, the transplantation of large cartilage or osteochondral fragments (allografts) is selected as an option. This technique has excellent clinical results and the success rate reaches 90%.

The constantly evolving research in the field of cartilage damage has also offered chondrocyte-based techniques. Healthy tissue is obtained from the patient’s own joint, out of which cells are isolated, which are subsequently implanted into synthetic collagen or hyaluronic acid membranes, in order to be placed onto the lesion area, so that a new cartilage can develop.
Accordingly, stem cells from the patient themselves are isolated and placed – an alternative and promising method of recovery is also the one using mesenchymal stem cells. The technique of autologous transplantation is selected for extensive lesions and consists in a solution for patients where other techniques have failed.

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