Autologous chondrocyte implantation: complex defects and combined procedures

Abstract The treatment of cartilage lesions is often difficult and challenging in the young, complex knee. It is not uncommon to find these lesions associated with complicating factors such as the lesions being uncontained, the presence of bony deficiency, or the involvement of multiple lesions. This chapter presents different approaches and techniques to help manage these surgical complications and outlines the importance of understanding the predisposing factors associated with chondral lesions and degradation. It addresses when and how to manage malalignment, joint instability, and inadequate meniscal function when using a cellular treatment option to treat the chondral lesion. The key to managing these complex cases is to make sure that all joint pathologies are addressed, ensuring that an environment conducive to a successful repair is created.