Articular Cartilage Injuries – What Physical Therapists NEED to Know

By dpope2020

February 28, 2025

ACI, articular cartilage, articular cartilage injury, Autologous Chondrocyte Implantation, cartilage injury, dan pope, evidence based practice, evidence-based medicine, fitness pain free, Knee, knee arthritis, knee cartilage, knee injury, knee pain, knee surgeon, knee surgery, MACI, Matrix-Induced Autologous Chondrocyte Implantation, Microfracture, OATs, orthopedic surgery, orthopedics, Osteochondral autologous transplantation, physical therapist, physical therapy, sports injury

Articular Cartilage Injuries - What Physical Therapists NEED to Know

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In today's video we go over Articular Cartilage Injuries - What Physical Therapists NEED to Know - FPF Show Episode 160

  • 0:00 Introduction
  • 2:36 What is an articular cartilage injury? (defect) 
  • 3:55 Does articular cartilage heal after an injury?
  • 4:52 What is the function of articular cartilage within the knee joint?
  • 7:57 How do we grade injury severity? and which grades are potential candidates for surgery?
  • 11:16 How common are articular cartilage injuries in the knee? (Incidence & Prevalence)
  • 13:47 Is the incidence higher in athletes? and are these injuries all symptomatic?
  • 14:21 Where in the knee are most patients getting injuries?
  • 17:10 What's the impact on a meniscus and / or ACL injury on articular cartilage?
  • 22:40 How do these patient present clinically?
  • 28:12 What subjective data helps us to rule in cartilage injuries?
  • 31:52 Is diagnostic imaging (MRI, X-ray) helpful for diagnosing articular cartilage injuries in the knee?
  • 33:08 What are the different types of surgeries indicated for patients with cartilage injuries?
  • 34:57 What is a microfracture procedure? Who is the best candidate for the surgery? Pros and cons of the surgery.
  • 37:04 Do microfracture procedures have good return to sport rates?
  • 40:27 What is the OATs procedure? Who is it best for? What are the pros and cons? How successful is this procedure for returning athletes to sport?
  • 43:05 What is the ACI? Who is it best for? What are the pros and cons? What are the return to sport rates?
  • 47:05 What is the MACI? Who is it best for? What are the pros and cons? What are the return to sport rates?
  • 49:05 What type of procedure is going to be best for YOUR patient?

Cartilage of a spring chicken...

- Dan Pope DPT,OCS,CSCS

Show Notes / Relevant Articles:

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Thank you!

Dan Pope DPT, OCS, CSCS

References: 

  1. Logerstedt DS, Scalzitti DA, Bennell KL, Hinman RS, Silvers-Granelli H, Ebert J, Hambly K, Carey JL, Snyder-Mackler L, Axe MJ, McDonough CM. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Revision 2018. J Orthop Sports Phys Ther. 2018 Feb;48(2):A1-A50. doi: 10.2519/jospt.2018.0301. PMID: 29385940.

  2. Brophy RH, Wright RW, David TS, et al. Association between previous meniscal surgery and the incidence of chondral lesions at revision anterior cruciate ligament reconstruction. Am J Sports Med. 2012;40:808-814. https://doi.org/10.1177/0363546512437722

  3. Goyal D, Keyhani S, Lee EH, Hui JH. Evidence-based status of microfracture technique: a systematic review of level I and II studies. Arthroscopy. 2013 Sep;29(9):1579-88. doi: 10.1016/j.arthro.2013.05.027. PMID: 23992991.

  4. Mithoefer K, Hambly K, Della Villa S, Silvers H, Mandelbaum BR. Return to sports participation after articular cartilage repair in the knee: scientific evidence. Am J Sports Med. 2009 Nov;37 Suppl 1:167S-76S. doi: 10.1177/0363546509351650. Epub 2009 Oct 27. PMID: 19861696.

  5. Jarecki J, Waśko MK, Widuchowski W, Tomczyk-Warunek A, Wójciak M, Sowa I, Blicharski T. Knee Cartilage Lesion Management-Current Trends in Clinical Practice. J Clin Med. 2023 Oct 10;12(20):6434. doi: 10.3390/jcm12206434. PMID: 37892577; PMCID: PMC10607427.

  6. Wang AS, Nagelli CV, Lamba A, Saris DBF, Krych AJ, Hevesi M. Minimum 10-Year Outcomes of Matrix-Induced Autologous Chondrocyte Implantation in the Knee: A Systematic Review. Am J Sports Med. 2024 Jul;52(9):2407-2414. doi: 10.1177/03635465231205309. Epub 2024 Feb 5. PMID: 38312085.

  7. Mall NA, Harris JD, Cole BJ. Clinical Evaluation and Preoperative Planning of Articular Cartilage Lesions of the Knee. J Am Acad Orthop Surg. 2015 Oct;23(10):633-40. doi: 10.5435/JAAOS-D-14-00241. Epub 2015 Sep 16. PMID: 26377673.

  8. Kunze KN, Mazzucco M, Thomas Z, et al. High Rate of Return to Sport for Athletes Undergoing Articular Cartilage Restoration Procedures for the Knee: A Systematic Review of Contemporary Studies. The American Journal of Sports Medicine. 2025;0(0). doi:10.1177/03635465241280975