Induction of The Fibrocartilage Growth
The group of treatments short of the total joint replacement can be divided into two groups. Shaving (chondrectomy) and debridement belong to the treatments that remove the diseased and undermined cartilage with an aim to temporarily relieve the autoimmune inflammation and pain. The other group of treatments includes a range of abrasive procedures, aimed at triggering of the cartilage production, like drilling, microfracture, chondroplasty, and spongialization. The high energy assisted treatments compose a third, experimental, category, as they combine the removal of the diseased cartilage, with cartilage reshaping, and an induction of the cartilage proliferation.
This is a piece of the diseased cartilage that was resected during an operation. The darker area in the middle is the sclerotic and unstable cartilage that is lost.
Image credit: CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
Number 391S, pp. S306–S317
Medial femoral condyle lesion
Image credit: Orthop Clin N Am 36 (2005) 419 – 426
However, it is important to remember that abrasion, drilling, and microfracture are the techniques that originated 20 years ago. They all rely on the phenomenon of the spontaneous repair of the tissue following the vascular injury to the subchondral plate of the bone. It has to be stressed that with abrasion and drilling the results are often irreproducible from center to center.