Cartilage Conundrums 2025: Cases From the Experts (2025 Annual Meeting)-Cartilage Conundrums 2025: Cases From the Experts

Video Transcription

Video Summary

The symposium focused on cartilage pathology treatment, emphasizing that most cartilage lesions seen during arthroscopy do not require surgical intervention. Experts including Dr. Rachel Frank, Dr. Aaron Kritsch, and Dr. Brian Cole highlighted the importance of managing patient expectations and comprehensive joint evaluation—including imaging, alignment, and potential instability—before deciding on treatment. Treatment options vary from simple arthroscopic debridement and loose body removal to more complex cartilage repair or reconstructive procedures such as osteochondral allografts, sometimes combined with osteotomies for malalignment.<br /><br />Cases discussed included a young woman with a patellar cartilage lesion treated successfully by arthroscopy without transplantation, and a 38-year-old man with medial femoral condyle cartilage damage and varus alignment, managed using fresh osteochondral allograft plus high tibial osteotomy. Technical pearls covered graft preparation, surgical sequencing (address cartilage then osteotomy), and deciding on screw types for fixation.<br /><br />A high-level athlete with prior meniscectomy and evolving cartilage delamination underwent meniscal allograft and osteochondral graft to preserve function despite risks and uncertain outcomes. The session emphasized careful diagnostic workup, individualized treatment plans balancing surgical aggressiveness with patient goals, and the significance of staging procedures. Non-operative treatments like physical therapy and biologic injections remain important adjuncts, but surgical solutions must consider the entire joint environment, including bone health and limb alignment, to optimize outcomes.

Asset Caption

Rachel M. Frank, M.D., FAANA | Brian J. Cole, M.D., FAANA | Paul E. Caldwell, M.D., FAANA | Aaron J. Krych, M.D., FAANA

Keywords

cartilage pathology

arthroscopy

cartilage lesions

osteochondral allograft

osteotomy

meniscal allograft

joint alignment

cartilage repair

non-operative treatment