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<p>Focal cartilage lesions of the knee joint frequently cause chronic symptoms and therefore require early treatment. Concomitant pathologies such as malalignment, ligamentous instability, or meniscal deficiency have a decisive impact on the outcome of cartilage regenerative procedures and must therefore be addressed concomitantly. Small chondral defects up to approximately 2&#xa0;cm<sup>2</sup> are commonly treated primarily by bone marrow stimulation (BMS), preferably using microdrilling techniques. For defects of approximately 1–4&#xa0;cm<sup>2</sup>, matrix-augmented bone marrow stimulation (m-BMS) is considered the standard of care, providing superior mid-term outcomes. Larger defects exceeding approximately 2&#xa0;cm<sup>2</sup> are preferentially treated with matrix-associated autologous chondrocyte transplantation (m-ACT), which has demonstrated stable long-term results. Osteochondral lesions require a combined treatment approach addressing both cartilage and subchondral bone. Overall, treatment follows a clearly defined stepwise concept based on epidemiological factors, defect morphology, concomitant pathologies, and structured rehabilitation.</p>

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Therapie von Knorpelschäden am Kniegelenk

  • 期刊论文

  • 发表日期：

    2026年1月8日

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  • Philip P. Rössler,
  • Christoph Becher

摘要

Focal cartilage lesions of the knee joint frequently cause chronic symptoms and therefore require early treatment. Concomitant pathologies such as malalignment, ligamentous instability, or meniscal deficiency have a decisive impact on the outcome of cartilage regenerative procedures and must therefore be addressed concomitantly. Small chondral defects up to approximately 2 cm2 are commonly treated primarily by bone marrow stimulation (BMS), preferably using microdrilling techniques. For defects of approximately 1–4 cm2, matrix-augmented bone marrow stimulation (m-BMS) is considered the standard of care, providing superior mid-term outcomes. Larger defects exceeding approximately 2 cm2 are preferentially treated with matrix-associated autologous chondrocyte transplantation (m-ACT), which has demonstrated stable long-term results. Osteochondral lesions require a combined treatment approach addressing both cartilage and subchondral bone. Overall, treatment follows a clearly defined stepwise concept based on epidemiological factors, defect morphology, concomitant pathologies, and structured rehabilitation.