A Basic Science Understanding of Cartilage Repair and Its Clinical Application

The highly organised and complex structure of the osteochondral unit creates a significant challenge for developing repair techniques and therapeutics. The innate repair response and current treatment options fail to produce reparative tissue with the intricate zonal architecture and function of native chondral tissue. The first part of this chapter highlights the normal macro- and microarchitecture and composition of the osteochondral unit, the influence of the zonal structural variations on function and the intrinsic response to chondral and osteochondral defects. The second part of this chapter presents the impact of pathological changes on the osteochondral unit and the basic science understanding of treatment options that overcome some of the intrinsic repair limitations to provide durable solutions.