How to Deal with Cartilage Lesions Based on the Size

Cartilage lesions are problematic because hyaline articular cartilage has limited ability to regenerate in response to damage. The size of the lesions is a determining factor in every algorithm of decision-making in terms of treatment. The decision if a cartilage lesion demands surgical treatment is depending on a variety of parameters and should always be reached mutually between physician and patient after thorough education about the risks and benefits of operative and conservative treatment options. Lesion characterization is often accomplished by the interpretation of advanced imaging studies (e.g., radiographs and magnetic resonance imaging [MRI]) and direct arthroscopic examination, which remains the gold standard to assess chondral/osteochondral pathology. A wide range of options for cartilage lesions is practised nowadays, ranging from conservative measures to simple arthroscopic interventions, marrow tapping techniques, osteochondral auto/allografting, cell-based techniques, growth factors, and emerging gene therapy techniques. Once a cartilage lesion is identified, multiple variables must be evaluated when determining treatment options. The patient’s clinical symptoms must correlate to physical examination and imaging findings to determine if the cartilage injury is the source of the patient’s pain. In this presentation, I tried to summarize how to deal with cartilage lesions based on their size.