title: The surgical management of symptomatic articular cartilage defects of the knee: Consensus statements from United Kingdom knee surgeons.
abstract: BACKGROUND
  Symptomatic articular cartilage and osteochondral lesions in the knee are an important source of pain and disability, and may lead to osteoarthritis. There are several surgical treatments for the condition, with emerging data evaluating their clinical effectiveness and longer-term clinical outcome. Health care providers have challenged the indications for the use of expensive techniques and have been reluctant to authorize funding or reimbursement.
  
  
  METHODS
  The UK Cartilage Consensus Meeting was convened, involving clinicians in the UK with experience in the treatment options, decision-making and evaluation of the literature on the subject.
  
  
  RESULTS
  This paper reports the consensus of attendees regarding appropriate surgical options for managing articular cartilage defects in the knee, validated by a large cohort of surgeons in the UK who are active in the field of articular cartilage surgery.
  
  
  CONCLUSIONS
  An evidence-based United Kingdom Consensus of 104 clinicians on the surgical management of symptomatic articular cartilage lesions of the knee. Several techniques may be suitable for small defects. Cell therapy has the best evidence-based outcomes for larger defects. Responsible innovation, pooled data collection and improvement in physical therapies are important. Surgeons should have access to the most appropriate evidence-based therapies for first-line treatment.
authors.affiliation: Edinburgh, United Kingdom. Electronic address: Leela.Biant@nhs.net.
authors.forename: Leela C
authors.initials: LC
authors.lastname: Biant
authors.affiliation: Liverpool, United Kingdom.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: McNicholas
authors.affiliation: Warwick, United Kingdom.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Sprowson
authors.affiliation: Warwick, United Kingdom.
authors.forename: Timothy
authors.initials: T
authors.lastname: Spalding
mesh_terms: D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D003625:Data Collection / Q000592:standards; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D019221:Mandatory Reporting; D019637:Orthopedic Procedures; D026741:Physical Therapy Modalities; D012955:Societies, Medical; D006113:United Kingdom
keywords: Articular cartilage; Cartilage repair; Consensus; Knee