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Bone marrow stimulation techniques such as abrasion arthroplasty, drilling and microfracture produce mostly fibrocartilage.
Treatment for such injuries is not trivial and includes bone marrow stimulation techniques, abrasion arthroplasty (debridement), drilling, micro-fracture, and mosaicplasty.
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.
Arthroscopy cannot be routinely recommended for AOA: otherwise, mild and moderate AOA can be addressed to arthroscopy, adding limited bone marrow stimulation techniques (Zgonis et al. 2006; Weatherall et al 2009) (Table 1).
In case of osteochondral lesions and early signs of AOA, bone marrow stimulation techniques have been usually performed, with quite good results even at long term follow-up (Kim et al. 2014).
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).
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The addition of BMAC to bone marrow stimulation (BMS) techniques significantly improved cartilage healing compared to BMS alone.
A pilot study was thus conducted to determine if bone marrow derived mesenchymal stromal cells (BM-MSCs) have modulatory effects on the repair outcomes of bone marrow stimulation (BMS) techniques.
These common repair techniques comprise debridement, bone marrow-stimulating techniques, osteochondral grafting, and autologous chondrocyte implantation (ACI) [ 2- 5].
Furthermore, bone marrow stimulation (for example, the microfracture technique) is not indicated in case of a subchondral bone defect or a loss of bone (osteochondrosis dissecans fragment) [ 27].
Clinical interventions such as marrow stimulation techniques that support cell invasion from the bone marrow do not restore the original cartilage structure and function in the lesions.
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