ARTICULAR-CARTILAGE - INJURIES AND POTENTIAL FOR HEALING

Impact and torsional joint loading can injure articular cartilage, cau sing pain, joint dysfunction and effusions, and, in some instances, pr ogressive joint degeneration. Differences in the type of injury and th e repair response distinguish three classes of articular surface injur ies: I) damage to the joint surface that leaves the articular surface intact but causes internal chondral damage and may cause subchondral b one injury, 2) mechanical disruption of the articular surface limited to articular cartilage, and 3) mechanical disruption of articular cart ilage and subchondral bone. A variety of treatments has the potential to improve healing of articular surfaces, including perforation of sub chondral bone, altered joint loading, periosteal and perichondrial gra fts, cell transplantation, growth factors, and artificial matrices. Se lection of treatment for a patient with an articular cartilage injury should be guided by an understanding of the type of injury, the potent ial for healing, and the effects of treatment on joint surface restora tion.