Cartilage defects represent a common problem in orthopaedic practice. Predisposing factors include traumas, inflammatory\r\nconditions, and biomechanics alterations. Conservative management of cartilage defects often fails, and patients with this lesions\r\nmay need surgical intervention. Several treatment strategies have been proposed, although only surgery has been proved to\r\nbe predictably effective. Usually, in focal cartilage defects without a stable fibrocartilaginous repair tissue formed, surgeons\r\ntry to promote a natural fibrocartilaginous response by using marrow stimulating techniques, such as microfracture, abrasion\r\narthroplasty, and Pridie drilling, with the aim of reducing swelling and pain and improving joint function of the patients.\r\nThese procedures have demonstrated to be clinically useful and are usually considered as first-line treatment for focal cartilage\r\ndefects. However, fibrocartilage presents inferior mechanical and biochemical properties compared to normal hyaline articular\r\ncartilage, characterized by poor organization, significant amounts of collagen type I, and an increased susceptibility to injury,\r\nwhich ultimately leads to premature osteoarthritis (OA). Therefore, the aim of future therapeutic strategies for articular cartilage\r\nregeneration is to obtain a hyaline-like cartilage repair tissue by transplantation of tissues or cells. Further studies are required to\r\nclarify the role of gene therapy and mesenchimal stem cells for management of cartilage lesions.
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