Physicians have known for over 250 years that articular cartilage damage is a “troublesome
thing and once destroyed, it is not repaired.”
1
Although chondral lesions that penetrate to or through the subchondral bone may fill
with fibrocartilage, the biomechanical and biochemical features remain inferior to
hyaline cartilage.
2
,
3
,
4
Unlike the recognized poor prognosis of the meniscectomized knee, the natural history
of chondral lesions remains far more speculative. At this juncture, treatment recommendations
are for those lesions believed to be contributing to a patient’s symptoms and are
not generally directed toward asymptomatic lesions. Clinical experience has taught
us that after these lesions become symptomatic (a cause of pain, swelling, mechanical
symptoms), they tend to persist or inexorably progress over an indeterminate time
course.To read this article in full you will need to make a payment
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© 2003 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
