Cartilage injuries of the knee occur frequently in professional and amateur athletes and can be associated with severe debilitation and morbidity. They are commonly associated with ligament injuries but also may be frequently isolated. Increasing awareness and advances in magnetic resonance imaging (MRI) have led to increasing diagnosis and recognition of these injuries. Articular cartilage is just 2 to 4 mm thick and is avascular, alymphatic, and aneural. It has a limited capacity for healing, and there has been increasing use of cartilage repair techniques to treat these lesions in the active population. Strategies for cartilage repair include marrow stimulation techniques such as microfracture/drilling, osteochondral grafting, and autologous chondrocyte transplants. MRI is an important tool in the diagnosis and grading of cartilage injury and is useful in the follow-up and monitoring of these repair procedures. It is important for radiologists and clinicians to be aware of the capabilities and limitations of MRI in assessing cartilage injury and to be familiar with common postsurgical appearances to facilitate assessment and follow-up in this population. This article reviews the clinical findings and MRI imaging appearances of cartilage injury. The management options are discussed as well as common postsurgical appearances following the various interventions.
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