AMIC vs MACI for knee cartilage repairStandalone microfracture for knee cartilage defects has less than 60% survivorship at three years; AMIC adds a collagen membrane to stabilize repair, whilst MACI uses cultured chondrocytes and shows superiority in the SUMMIT trial for lesions over 3 cm².Standalone microfracture for knee cartilage defects has less than 60% survivorship at three years; AMIC adds a collagen membrane to stabilize repair, whilst MACI uses cultured chondrocytes and shows superiority in the SUMMIT trial for lesions over 3 cm².
How single-stage ACI differs from MACIMACI repairs cartilage defects over two operations, with weeks between them for external cell expansion; STACi compresses the entire process—harvesting, processing, and implantation—into a single surgical session.MACI repairs cartilage defects over two operations, with weeks between them for external cell expansion; STACi compresses the entire process—harvesting, processing, and implantation—into a single surgical session.
Who treats tennis elbow and what to askTennis elbow is tendinopathy, not inflammation: small tears in the ECRB tendon accumulate faster than the tissue repairs itself, and progressive eccentric loading stimulates remodelling whereas rest prolongs recovery.Tennis elbow is tendinopathy, not inflammation: small tears in the ECRB tendon accumulate faster than the tissue repairs itself, and progressive eccentric loading stimulates remodelling whereas rest prolongs recovery.
How defect size and age decide OATS or OCADefect size determines whether focal cartilage repair uses autograft (OATS, harvested from the patient's own knee) or donor allograft (OCA): below 2 cm², autograft is viable; above 4 cm², only allograft remains before arthroplasty.Defect size determines whether focal cartilage repair uses autograft (OATS, harvested from the patient's own knee) or donor allograft (OCA): below 2 cm², autograft is viable; above 4 cm², only allograft remains before arthroplasty.
Who treats supraspinatus tendinopathy and when to scanSupraspinatus tendinopathy presents as gradually worsening outer-shoulder pain, worse with overhead reaching. A load-related tendon change distinct from structural tears, it resolves with physiotherapy in primary care for most patients; imaging and specialist assessment follow only when conservative care has not succeeded.Supraspinatus tendinopathy presents as gradually worsening outer-shoulder pain, worse with overhead reaching. A load-related tendon change distinct from structural tears, it resolves with physiotherapy in primary care for most patients; imaging and specialist assessment follow only when conservative care has not succeeded.
Who qualifies for MACI knee surgeryMACI grows hyaline-like cartilage from the patient's own cells and maintains superior pain and function scores at five years, unlike microfracture, whose fibrocartilage typically deteriorates within two to three years.MACI grows hyaline-like cartilage from the patient's own cells and maintains superior pain and function scores at five years, unlike microfracture, whose fibrocartilage typically deteriorates within two to three years.
Which specialist treats AC joint painThe acromioclavicular joint, where the outer collarbone meets the shoulder blade, transfers all load from the arm to the skeleton — a role accounting for roughly 40% of all shoulder injuries.The acromioclavicular joint, where the outer collarbone meets the shoulder blade, transfers all load from the arm to the skeleton — a role accounting for roughly 40% of all shoulder injuries.
Who qualifies for OATS knee surgeryOATS transplants hyaline cartilage harvested from a low-load zone of the same knee to repair focal defects. The donor site heals with fibrocartilage, creating potential for catching, locking, or anterior knee pain.OATS transplants hyaline cartilage harvested from a low-load zone of the same knee to repair focal defects. The donor site heals with fibrocartilage, creating potential for catching, locking, or anterior knee pain.
When shoulder impingement pain needs a specialistStructured physiotherapy resolves shoulder impingement pain in 60–90% of cases. Specialist referral is warranted if pain persists after three months of treatment, or sooner if it disturbs sleep or restricts overhead arm movement.Structured physiotherapy resolves shoulder impingement pain in 60–90% of cases. Specialist referral is warranted if pain persists after three months of treatment, or sooner if it disturbs sleep or restricts overhead arm movement.
ACI or MACI for knee cartilage repairBoth ACI and MACI require two operations: stage-1 biopsy yields too few chondrocytes for immediate repair, so stage-2 implantation must follow 3–6 weeks of laboratory expansion.Both ACI and MACI require two operations: stage-1 biopsy yields too few chondrocytes for immediate repair, so stage-2 implantation must follow 3–6 weeks of laboratory expansion.
Hip osteoarthritis treatment before replacement surgeryUK clinical guidance requires documented completion of conservative care — physiotherapy, weight management, analgesia — before accepting a total hip replacement referral. Surgical timing is determined by functional impact, not imaging severity.UK clinical guidance requires documented completion of conservative care — physiotherapy, weight management, analgesia — before accepting a total hip replacement referral. Surgical timing is determined by functional impact, not imaging severity.
When hip pain needs a specialistHip pain persisting beyond two weeks, disrupting sleep or preventing stairs and dressing, warrants GP assessment; specialist referral typically requires prior documentation of 8–12 weeks of conservative management.Hip pain persisting beyond two weeks, disrupting sleep or preventing stairs and dressing, warrants GP assessment; specialist referral typically requires prior documentation of 8–12 weeks of conservative management.