Articular cartilage defects - the extent of the problem

It wasn't until I found myself in the position of being a prospective patient for articular cartilage repair that I decided to do a bit of reading around the area. Now you may think that as I am a fully qualified chartered physiotherapist that I should have known all about articular cartilage problems and how they are managed. The reality of things is that the only time in the whole of my physio training that articular cartilage was ever mentioned was in relation to osteoarthritis. Now before anyone makes a rude comment about the fact that I did my training in the dark ages before articular cartilage repair techniques had been developed - this wasn't the case. Yes, some of the newer cell based repairs such as autologous chondrocyte implantation weren't on the scene but orthopaedic surgeons were out there performing various shaving and drilling techniques to address articular cartilage problems.

So, perhaps the lack of awareness and education is because articular cartilage problems are really rare and unusual? Well no, this is not the case. The startling fact is that 4-11% of patients who have a knee arthroscopy are found to have articular cartilage defects. Now it is important to note that not all of these defects are or will be problematic for the person. Determining which defects will or won't be problematic is a real can of worms and at present no-one has come up with a conclusive answer on this one. However, if you think about the number of knee arthroscopies that are performed around the world each year you can get an idea of the scale of the problem.