Editorial Commentary: The Number of Cartilage Treatment Options Continues to Grow, Despite the Lack of High-Quality Comparative Studies?

A growing number of knee cartilage repair studies continue to be published, employing both traditional and also novel and emerging surgical methods. Marrow stimulation, osteochondral transplantation, and autologous chondrocyte implantation via varied surgical techniques and delivery methods exist, as well as isolated, or concomitant, realignment procedures. However, while some value exists in small clinical cohorts (prospective and retrospective), we still lack high-quality comparative studies that better direct us toward the ideal cartilage repair treatment, specific to each individual patient situation including chondral defect (size, location, shape, etc.), the local environment (early degenerative knee changes, concomitant pathology), the surrounding environment (including individual physical conditioning and lower-limb alignment), and of course the patient's tolerance to the pathology and individual physical demands. How do we sort this out? High-quality, and hopefully prospective and randomized, clinical trials are required.