Aim: To review the literature on management of articular cartilage injuries in elite athletes with a focus on new developments. Background: Articular cartilage injury is a common problem that can lead to significant pain and loss of function. This tissue has a poor healing capacity due to its avascular and aneural status. No treatment option has been completely successful in stimulating articular cartilage repair and regeneration. Such an injury in a professional athlete could turn out to be a performance- or a career-ending event. There is a dearth of evidence on the treatment of articular cartilage injuries in athletes. Hence, we reviewed available evidence on the management of articular cartilage injuries in professional athletes. Materials and methods: A key word search was done on PubMed, Scopus, EMBASE, and Ovid Medline. After filtering, 89 articles were reviewed to extract available evidence on the subject. Results: Overall there are few good-quality reports on the outcomes of cartilage repair and reconstruction techniques, specifically in professional athletes. Most reports are case series or reports. Most commonly involved areas include the femoral condyles, femoral heads, talus, humerus condyles, and the humeral head. Various treatment options have been tried and include chondroplasty, microfracture and its various modifications, bilayered autograft and allograft transplantation, and cell-based regenerative techniques (platelet-rich plasma, autologous cultured chondrocytes, and mesenchymal cells). Conclusion: While most treatment methods have produced good results in the short- and mid-term, little good-quality evidence is available on their long-term results. The newer techniques such as tissue engineering methods, 3D bioprinting, and gene therapy appear to be promising. But these are still in preclinical state and are likely to pave way to better treatment options in the future. Clinical significance: Elite athletes are a challenging group of patients who require exacting techniques, more demanding than the general population, to restore their function and return to play at same level. Current available techniques restore their function to a large extent, but outcomes may be improved. Cartilage restoration techniques are evolving, and newer techniques are developing to improve outcomes.
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