Articular chondral and osteochondral injuries of the knee are common in people aged under 35 years, and symptomatic lesions left untreated may lead to chronic pain and disability. Patients with articular chondral injuries often have a poorer function score than those awaiting surgery for other knee disorders, such as osteoarthritis or a ruptured anterior cruciate ligament.1 Patients with articular cartilage injuries may go on to develop early onset osteoarthritis with long term morbidity and consequent high use of health service resources; successful early treatment of these lesions would probably be cost effective.

Chondral and osteochondral lesions may not be diagnosed or may present late because patients will often give a history of an apparent insignificant trauma and doctors may fail to understand the importance of an effusion in the knee joint, which always indicates joint disease.2 Radiographs of the knee may be poorly interpreted. This review discusses the diagnosis and management (conservative and surgical) of injuries to the articular cartilage of the knee and draws on published research articles and the authors’ own experience.