ABSTRACT
Despite the success with which total joint prostheses are able to relieve pain and restore meaningful function to diseased joints, problems with joint arthroplasty remain. Concern regarding the longevity of prosthetic joints in young active patients and the profound consequences of multiple revision procedures has drawn attention to techniques for treating cartilage defects before they become symptomatic and involve the majority of the joint surface. The widespread implementation of arthroscopy and the improvements in imaging modalities have enabled the identification of defects in the articular surface that are likely to predispose to an arthritic condition. New treatment modalities hold the promise of inducing a reparative tissue in these defects that will yield pain-free function for a meaningful period, thus delaying the need for total joint arthroplasty. The early success achieved in treating these defined circumscribed lesions has also now led to a reconsideration of
methodology for the treatment of the frankly arthritic joint to achieve a biological solution to the problem, as an alternative to prosthetic replacement.
