title: The present state of treatments for articular cartilage defects in the knee.
abstract: BACKGROUND
  Chondral and osteochondral lesions of the knee are notoriously difficult to treat due to the poor healing capacity of articular cartilage and the hostile environment of moving joints, ultimately causing disabling pain and early osteoarthritis. There are many different  reconstructive techniques used currently but few are proven to be of value. However, some have been shown to produce a better repair with hyaline-like cartilage rather than fibrocartilage.
  
  
  METHODS
  A systematic search of all available online databases including PubMed, MEDLINE(®)  and Embase™ was undertaken using several keywords. All the multiple treatment options and methods available were considered. These were summarised, and the evidence for and against them was scrutinised.
  
  
  RESULTS
  A total of 460 articles were identified after cross-referencing the  database searches using the keywords. These revealed that autologous and matrix assisted chondrocyte implantation demonstrated both 'good to excellent' histological results and significant improvement in clinical outcomes.
  
  
  CONCLUSIONS
  Autologous and matrix assisted chondrocyte implantation  have been shown to treat symptomatic lesions successfully with significant histological and clinical improvement. There is, however, still a need for further randomised clinical trials, perfecting the type of scaffold and the use of adjuncts such as growth factors. A list of recommendations  for treatment and the potential future trends of managing these lesions are given.
authors.affiliation: Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex HA7 4LP, UK. jonathan_perera@hotmail.com
authors.forename: J R
authors.initials: JR
authors.lastname: Perera
authors.forename: P D
authors.initials: PD
authors.lastname: Gikas
authors.forename: G
authors.initials: G
authors.lastname: Bentley
mesh_terms: D002357:Cartilage Diseases / Q000175:diagnosis / Q000628:therapy*; D002358:Cartilage, Articular; D019902:Chondrocytes / Q000637:transplantation; D005544:Forecasting; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000627:therapeutic use; D007592:Joint Diseases / Q000175:diagnosis / Q000628:therapy*; D007719:Knee Joint; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods; D020370:Osteoarthritis, Knee / Q000628:therapy; D054457:Tissue Scaffolds; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
chemical_list: D036341:Intercellular Signaling Peptides and Proteins