The treatment of cartilage defects in the knee joint: microfracture, mosaicplasty, and autologous chondrocyte implantation.

The efficacy of microfracture (MF), mosaicplasty (MO), and autologous chondrocyte implantation (ACI) techniques are still a matter of debate. This review aims to analyze comparative studies of these techniques, review the results of no treatment, and the natural history of untreated articular cartilage lesions. A PubMed search on the topic was performed. The most important (14) articles, as judged by the author, were selected for this review. There is limited evidence that any intervention significantly alters the natural history of these lesions and there is no evidence of significant difference between ACI and MF and MO. Paramount for successful surgical cartilage repair is a stable knee with a well-aligned lower limb. There is insufficient evidence at present to say that ACI is cost-effective, compared with MF or MO.