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AAOS 2001 Articular Cartilage Injury in the Athlete
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AAOS 2001 Articular Cartilage Injury in the Athlete
AAOS 2001, San Francisco, CA

Articular Cartilage Injury in the Athlete: Treatment Options in 2001, Instructional Course Lecture 293

  • Michael G. Ciccotti, MD(moderator)*
  • John Garrett, MD
  • Laszlo Hangody, MD, PhD
  • Bert Mandelbaum, MD*
  • Lars Peterson, MD, PhD
  • Richard Steadman, MD


*PTP member

Treatment options for articular cartilage injury in the athletic patient were reviewed in this Instructional Course Lecture. Dr. Steadman presented his results with the micro-fracture technique, Dr. Hangody discussed osteochondral autograft transplantation, Dr. Peterson covered autologous chondrocyte implantation and Dr. Garrett reviewed osteochondral allografting.

Articular Cartilage Repair Algorithm for 10 Most Common Clinical Problems (Bert Mandelbaum, MD)

1. Diagnosis: Meniscus tears and partial thickness articular cartilage defect.

Treatment: Arthroscopic debridement and partial menisectomy.

2. Diagnosis: 2 Femoral articular cartilage defects
less than 1 cm2

Treatment: Debridement, micro-fracture technique, or
osteochondral grafting in selected cases


3. Diagnosis: Femoral articular cartilage defects
1-2 cm2 with or without osteochondral defect

Treatment: Debridement, microfracture technique,osteochondral grafting(OCG), or autologous chondrocyte implantation(ACI)

4. Diagnosis: Femoral articular cartilage defects >2 cm2 with or without osteochondral defect

Treatment: Autologous chondrocyte implantation or osteochondral allografting

5. Diagnosis: Femoral articular defects including complex malalignment, or ligament and meniscal deficiency

Treatment: Osteotomy, meniscal allograft cruciate reconstruction, or Autologous chondrocyte implantation or osteochondral allografting depending on size

6. Diagnosis: Patella and trochlear articular defects without malignment or instability

Treatment: Physical therapy, more PT and bracing, arthroscopy and lateral release, or autologous chondrocyte implantation +/- Fulkerson osteotomy

7. Diagnosis: Patella and trochlear articular defects and significant malalignment

Treatment: Physical therapy, autologous chondrocyte implantation +/- Fulkerson osteotomy +/- VMO reefing

8. Diagnosis: Tibial articular cartilage defects without malalignment

Treatment: Osteotomy as needed

9. Diagnosis: 30-60 year old degenerative meniscal tears and global grade III/IV articular cartilage defects(very common in early osteoarthritis)

Treatment: NSAIDs / Cox-2 inhibitors, hyaluronic acid, glucosamine / chondroitin sulfate, bike for exercise, unloading braces, arthroscopy +/- micro-fracture, or osteotomy selectively

10. Diagnosis: Degenerative meniscal tears and global grade IV articular cartilage defects(common in late osteoarthritis

Treatment: NSAIDs / Cox-2 inhibitors, hyaluronic acid, glucosamine / chondroitin sulfate, bike for exercise, unloading braces, arthroscopy +/- micro-fracture, or osteotomy selectively


Compiled by Jan Fronek, MD, PTP Member and San Diego Padres Team Physician