Popularity and volume of biological repair for cartilage lesions of the knee have increased substantially in the last decade. However, even with current techniques, ∼25% of patients treated with primary cartilage repair will experience failure of the procedure and likely require further surgery, either revision cartilage repair or conversion to arthroplasty. Factors such as age, activity level, malalignment, meniscal integrity, ligamentous instability and type of prior cartilage repair technique influence the indications and outcomes of revision biological repair. In this state-of-the-art review paper, the authors discuss the contributing factors for, and principles of, failed cartilage repair and its management.
Competing interests None declared.
Provenance and peer review Commissioned; externally peer reviewed.