Patient Evaluation and Surgical Decision Making

摘要

Treatment of damaged articular cartilage is a challenging process through which the patient and physician navigate together. Because articular cartilage lesions have limited capacity to heal themselves, identifying the optimal treatment plan for a particular type of cartilage lesion is critical to achieve symptom reduction and improvements in function.Choosing the optimal treatment is a particular process, as each treatment option embodies biologic, biomechani-cal, and technical factors. Additionally, with consideration to relevant comorbidities, the specific treatment option must appropriately be matched to the patient and the general condition of the knee. Finally, the patient's psychoso-cial disposition and the pathoanatomy leading to their subjective complaints and objective dysfunction must also be considered to appreciate the entire patient picture.Treatment selection is, therefore, predicted on patient- and knee-specific articular cartilage factors.The purpose of this article is not to review the specific techniques, indications, or results of available treatment options, which are well described elsewhere,1115" but rather to present a rational, patient- and knee-specific demand-match approach to the treatment of articular cartilage lesions.