Knee joint preservation throughout life

Maintaining healthy knees is crucial for mobility and quality of life. This thesis explores how to preserve the knee joint, especially in middle-aged patients who often fall between regenerative and replacement options. It presents a modified surgical technique for reattaching cartilage fragments in young patients, showing excellent healing and full return to sports. A review of existing treatments found that microfracture procedures perform poorly in older patients, while bone-based methods such as osteochondral grafts and focal knee resurfacing implants (FKRIs) show better long-term results. A national survey revealed that many Dutch surgeons still use outdated treatments, highlighting the need for better education and guideline adherence. Finally, the thesis introduces a new implant made from polycarbonate-urethane (PCU) and zirconium oxide, offering a durable, MRI-compatible alternative to metal implants. Overall, it emphasizes smarter, age-specific strategies to delay or prevent knee replacement surgery.