ICL 107 State of the Art Approach to Chondral Injury-Overview of Options and Discussion

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Video Summary

The discussion centers on cartilage repair techniques, particularly microfracture, post-op care, and emerging stem cell therapies. Experts agree that hyaluronic acid (HA) may aid healing post-microfracture, supported by animal studies, but regulatory and insurance hurdles limit its use. Alternative materials like Seprafilm (HA-based anti-adhesion membrane) show promise for reducing inflammation. Stem cell treatments, especially using bone marrow aspirate concentrated cells (BMAC), are gaining interest but lack robust clinical data; ongoing randomized trials aim to clarify their effectiveness. Concerns over costly, unproven "stem cell" therapies offered outside orthopedics were expressed, highlighting the need for evidence-based practices. Surgical strategies for cartilage delamination, bipolar lesions, and osteochondral defects involve various grafts, membrane seeding, and proper joint alignment techniques, emphasizing individualized patient considerations. Continuous passive motion (CPM) post-microfracture may help but is not critical if adequate joint movement occurs. Osteotomies remain valuable, and conservative approaches are favored before total joint replacement in younger patients. Overall, cautious optimism guides evolving cartilage repair and regenerative therapies.

Keywords

cartilage repair

microfracture

stem cell therapy

hyaluronic acid

Seprafilm

osteotomies