System and methods for stimulating cartilage formation at a first tissue site through a second tissue site is presented. The system includes a fluid source for supplying a therapeutic solution, a reduced pressure source for supplying reduced pressure, a fluid delivery manifold for deploying adjacent the first tissue site, and a vacuum manifold for deploying within the second tissue site. The fluid delivery manifold extends between a proximal end fluidly coupled to the fluid supply and a distal end having at least one aperture for delivering the therapeutic solution to the defect adjacent the articulating surface of the first tissue site. The vacuum manifold extends between a proximal end fluidly coupled to the reduced pressure source and a distal end having at least one aperture for delivering the reduced pressure to the first tissue site adjacent the opposing surface of the first tissue site.
