:format(webp)/cdn.mskdoctors.com/storage/2026/9/X13JhdfZ3z055yRfjVjZRvr9SYpiXABH.jpg)
OATS or OCA for osteochondral knee repairDefect size is the primary determinant in osteochondral knee repair: lesions under 2–4 cm² are treated with OATS (autograft plugs), larger defects with OCA (fresh donor tissue), a distinction reflecting the limits of safe tissue harvest from the patient's own knee.Defect size is the primary determinant in osteochondral knee repair: lesions under 2–4 cm² are treated with OATS (autograft plugs), larger defects with OCA (fresh donor tissue), a distinction reflecting the limits of safe tissue harvest from the patient's own knee.
:format(webp)/cdn.mskdoctors.com/storage/2026/9/dGz4biYPYjDNZLwXfsZMbwgJVQPH4w27.jpg)
When to See a Cartilage SpecialistA man in his fifties has a 35% lifetime risk of revision joint replacement surgery, versus 5% for a man in his seventies. Implants fail with time; addressable cartilage lesions in younger patients can be managed without joint replacement.A man in his fifties has a 35% lifetime risk of revision joint replacement surgery, versus 5% for a man in his seventies. Implants fail with time; addressable cartilage lesions in younger patients can be managed without joint replacement.
:format(webp)/cdn.mskdoctors.com/storage/2026/9/mP9mx0iRFEXxgRYiW7bPveLR8fmUTRKl.jpg)
OATS vs microfracture for active knee patientsOATS (osteochondral autograft transfer) achieves excellent or good outcomes in 87.5% of active patients at ten years, compared with 63% for microfracture; the gap widens rather than narrows over time.OATS (osteochondral autograft transfer) achieves excellent or good outcomes in 87.5% of active patients at ten years, compared with 63% for microfracture; the gap widens rather than narrows over time.
:format(webp)/cdn.mskdoctors.com/storage/2026/9/vtbenxNBVXxF5RYWicCH4HedXFHeRy9y.jpg)
ACI for ankle osteochondral lesionsLarge osteochondral lesions of the talus or those failing prior repair can be treated with ACI, but accessing the defect typically requires a medial malleolar osteotomy — a bone cut that extends surgical recovery beyond equivalent knee procedures.Large osteochondral lesions of the talus or those failing prior repair can be treated with ACI, but accessing the defect typically requires a medial malleolar osteotomy — a bone cut that extends surgical recovery beyond equivalent knee procedures.
:format(webp)/cdn.mskdoctors.com/storage/2026/9/QTKrBpcdGygrOBvOONuIulDc3CEWtXu8.jpg)
Is cartilage repair right for your joint?Articular cartilage cannot heal itself: it lacks blood vessels and nerve supply, so focal defects enlarge rather than fill, requiring surgical repair when conservative management fails.Articular cartilage cannot heal itself: it lacks blood vessels and nerve supply, so focal defects enlarge rather than fill, requiring surgical repair when conservative management fails.
:format(webp)/cdn.mskdoctors.com/storage/2026/9/EjnaQIwv9xcmsFBAJ0d7fO9vpCduMCCB.jpg)
Single-stage cartilage repair versus ACI and MACISTACI harvests and implants cartilage within a single theatre session, combining it with bone-marrow cells to stimulate repair; conventional ACI and MACI require two procedures separated by six to eight weeks of external cell culture.STACI harvests and implants cartilage within a single theatre session, combining it with bone-marrow cells to stimulate repair; conventional ACI and MACI require two procedures separated by six to eight weeks of external cell culture.
:format(webp)/cdn.mskdoctors.com/storage/2026/8/yLTRuYlDDib8XUrlSNriNtmQoMd84zVg.jpg)
MACI Recovery From Six Weeks to Two YearsOnly a third of MACI patients return to their pre-operative sport level, despite most achieving pain-free function within six months and return to sport by 12–18 months. Kinesiophobia—fear of re-injury—emerges as a statistically significant independent predictor of this shortfall, distinct from tissue maturity.Only a third of MACI patients return to their pre-operative sport level, despite most achieving pain-free function within six months and return to sport by 12–18 months. Kinesiophobia—fear of re-injury—emerges as a statistically significant independent predictor of this shortfall, distinct from tissue maturity.
:format(webp)/cdn.mskdoctors.com/storage/2026/8/JylX06NyvYs2u029H0pRDVygq3TIlUh8.jpg)
MACI or knee replacement for younger patientsYoung patients accepting total knee replacement face a 35% lifetime probability of revision surgery; MACI cartilage repair preserves the native knee in nine out of ten well-selected cases over ten years.Young patients accepting total knee replacement face a 35% lifetime probability of revision surgery; MACI cartilage repair preserves the native knee in nine out of ten well-selected cases over ten years.
:format(webp)/cdn.mskdoctors.com/storage/2026/8/SBmsVEyBqtof0WMPbvBeYdD1nSFHZHd2.jpg)
Unloader knee brace or surgery for cartilage damageUnloader braces open the joint 0.3 mm, modulating cartilage chemistry without rebuilding damage; high tibial osteotomy substantially outperforms bracing for pain relief in younger patients.Unloader braces open the joint 0.3 mm, modulating cartilage chemistry without rebuilding damage; high tibial osteotomy substantially outperforms bracing for pain relief in younger patients.
:format(webp)/cdn.mskdoctors.com/storage/2026/8/sirSlJw4BFokznV0rGSVK1GCXRlJZuWi.jpg)
OATS mosaicplasty for sports knee cartilage repairIn a ten-year trial of athletes, osteochondral autograft transfer showed 14% treatment failure versus 38% for microfracture, a divergence emerging between years five and ten because fibrocartilage stimulated by microfracture degrades under repetitive athletic loading whilst transplanted hyaline cartilage retains structural integrity.In a ten-year trial of athletes, osteochondral autograft transfer showed 14% treatment failure versus 38% for microfracture, a divergence emerging between years five and ten because fibrocartilage stimulated by microfracture degrades under repetitive athletic loading whilst transplanted hyaline cartilage retains structural integrity.
:format(webp)/cdn.mskdoctors.com/storage/2026/8/2aQwmM1AYBNyJU4BaVz8KBQ2Vit6dIYs.jpg)
OATS or OCA for knee cartilage repairOATS transplants the patient's own cartilage-and-bone plugs for knee defects up to roughly 2 cm² whilst OCA uses shaped donor tissue for larger repairs, but prior failed surgery or subchondral bone loss shifts the choice to OCA regardless of size.OATS transplants the patient's own cartilage-and-bone plugs for knee defects up to roughly 2 cm² whilst OCA uses shaped donor tissue for larger repairs, but prior failed surgery or subchondral bone loss shifts the choice to OCA regardless of size.
:format(webp)/cdn.mskdoctors.com/storage/2026/8/bwZtSBcMngYTVd0Ea9Zvwh22yrzaDzib.jpg)
ACI versus MACI for knee cartilage repairCartilage defect size on MRI drives the choice between single-stage repair (AMIC, OATS) and two-stage cell therapy (MACI): below 2–4 cm², simpler alternatives often provide comparable results; at 3 cm² or larger, MACI demonstrates superiority.Cartilage defect size on MRI drives the choice between single-stage repair (AMIC, OATS) and two-stage cell therapy (MACI): below 2–4 cm², simpler alternatives often provide comparable results; at 3 cm² or larger, MACI demonstrates superiority.
