Migliorini Filippo, Simeone Francesco, Bardazzi Tommaso, Memminger Michael Kurt, Pipino Gennaro, Vaishya Raju, Maffulli Nicola
Department of Trauma and Reconstructive Surgery, University Hospital of Halle, Martin-Luther University Halle-Wittenberg, 06097 Halle (Saale), Germany.
Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), via Lorenz Böhler 5, 39100 Bolzano, Italy.
Cells. 2025 Aug 7;14(15):1217. doi: 10.3390/cells14151217.
Focal chondral defects of the knee are a common cause of pain and functional limitation in active individuals and may predispose to early degenerative joint changes. Given the limited regenerative capacity of hyaline cartilage, biologically based surgical strategies have emerged to promote tissue repair and restore joint function. This narrative review critically examines current treatment approaches that rely on autologous cell sources and scaffold-supported regeneration. Particular emphasis is placed on techniques that stimulate endogenous repair or support chondrocyte-based tissue restoration through the use of autologous biomaterial constructs. The influence of lesion morphology, joint biomechanics, and patient-specific variables on treatment selection is discussed in detail, focusing on the differences between tibiofemoral and patellofemoral involvement. Biologically driven approaches have shown promising mid- to long-term outcomes in selected patients, and are increasingly favoured over traditional methods in specific clinical scenarios. However, the literature remains limited by heterogeneity in study design, follow-up duration, and outcome measures. This review aims to provide an evidence-based, morphology-informed framework to support the clinical decision-making process in the management of knee cartilage defects.
膝关节局灶性软骨缺损是活跃人群疼痛和功能受限的常见原因，可能会导致早期关节退变。鉴于透明软骨的再生能力有限，基于生物学的手术策略应运而生，以促进组织修复并恢复关节功能。本叙述性综述批判性地审视了当前依赖自体细胞来源和支架支持再生的治疗方法。特别强调了通过使用自体生物材料构建体来刺激内源性修复或支持基于软骨细胞的组织修复的技术。详细讨论了病变形态、关节生物力学和患者特定变量对治疗选择的影响，重点关注胫股关节和髌股关节受累之间的差异。在特定患者中，生物驱动方法已显示出良好的中长期效果，并且在特定临床场景中越来越受到青睐，优于传统方法。然而，研究设计、随访时间和结局指标的异质性使得相关文献仍然有限。本综述旨在提供一个基于证据、形态学指导的框架，以支持膝关节软骨缺损管理中的临床决策过程。
