Bone marrow stimulation techniques such as abrasion arthroplasty, drilling and microfracture produce mostly fibrocartilage.
Marrow stimulation procedures promote cartilage repair by stimulating bone marrow through the subchondral bone and by producing blood clots containing MSCs on the articular surface (Madry et al. 2010).
Current clinical procedures include bone marrow stimulation techniques, cartilage plug transplant, and expanded autologous chondrocyte implantation (Camp et al. 2014; Steadman et al. 2003; Brittberg et al. 1994; Peterson et al. 2003; Hangody et al. 2001).
Surgical strategies for the treatment of osteochondral defects of the stifle include debridement, curettage of the lesion and bone marrow stimulation with microfracture [ 1], or restorative procedures such as osteochondral autograft transfer (OAT) [ 2- 4].
This physiological repair response still forms the rationale behind a number of orthopaedic procedures described as bone marrow stimulation techniques [ 19, 20].
Beside bone marrow stimulation techniques (microfractures) and autologous osteochondral mosaicplasty, a variety of procedures have been proposed to promote the healing of articular lesions by cultured competent cells.
Realignment procedures are effective, restoring joint congruity and uniform loading, but a correct pre-operative plan must be performed; associate procedures on soft tissues and arthroscopic bone marrow stimulation may improve the results (Table 1).
For repair of cartilage, bone marrow stimulation, mosaicplasty, and autologous chondrocyte implantation are currently the most commonly performed procedures [ 14].
IV osteochondral lesions Abbreviations are as follows: BMAC bone marrow aspirate concentrate, BMS bone marrow stimulation, AL anterolateral, CL centrolateral, PL posterolateral, AM anteromedial, CM centromedial, PM posteromedial.
