Can chondroplasty or an unloader brace helptrims and smooths damagedkneecartilage to ease catchingtrims and smooths damaged knee cartilage to ease catching
Conservative management for Bone Marrow Edema, Early stages of SONK (and PEMF)Spontaneous Osteonecrosis of theKnee(SONK) can severely affectSpontaneous Osteonecrosis of the Knee (SONK) can severely affect
Recovery After OATS for Ankle Cartilage Repairhealthy graft from theknee, producing hyaline-like tissue ratherhealthy graft from the knee, producing hyaline-like tissue rather
When cartilage repair is the right choiceCartilage repair is suited to younger, active patients with isolated damage in otherwise healthy joints where conservative care has not worked. It is mechanistically impossible when underlying bone is worn smooth, degeneration spans multiple compartments, or malalignment and instability persist uncorrected.Cartilage repair is suited to younger, active patients with isolated damage in otherwise healthy joints where conservative care has not worked. It is mechanistically impossible when underlying bone is worn smooth, degeneration spans multiple compartments, or malalignment and instability persist uncorrected.
Ten-Year Success Rates for OATS MosaicplastyTen-year success rates for OATS mosaicplasty span 72–89% in young, active patients; failure rates drop to 12.5–14% in optimal candidates (under 40, lesion under 3 cm²) but rise to 38–40% in older patients with larger defects.Ten-year success rates for OATS mosaicplasty span 72–89% in young, active patients; failure rates drop to 12.5–14% in optimal candidates (under 40, lesion under 3 cm²) but rise to 38–40% in older patients with larger defects.
Choosing between ACI and MACI for cartilage repairMACI cartilage grafts show 90% fill at two years but decline to 49% by ten years; 73% become fibrocartilage rather than the hyaline cartilage needed for durability.MACI cartilage grafts show 90% fill at two years but decline to 49% by ten years; 73% become fibrocartilage rather than the hyaline cartilage needed for durability.
MACI recovery and return to sportMACI recovery takes twelve to eighteen months before high-impact sport. Most patients return to some sport, but only one-third reach their pre-injury level — a gap significantly driven by kinesiophobia, which clinical teams can screen and address through sports psychology support.MACI recovery takes twelve to eighteen months before high-impact sport. Most patients return to some sport, but only one-third reach their pre-injury level — a gap significantly driven by kinesiophobia, which clinical teams can screen and address through sports psychology support.
Single-stage vs two-stage ACI for cartilage repairTraditional two-stage ACI involves two general anaesthetics separated by a four-to-six-week cell culture period; STACI performs both stages in a single theatre session, requiring one general anaesthetic and eliminating the inter-stage gap.Traditional two-stage ACI involves two general anaesthetics separated by a four-to-six-week cell culture period; STACI performs both stages in a single theatre session, requiring one general anaesthetic and eliminating the inter-stage gap.
Single-stage or two-stage cartilage repairCartilage repair decisions hinge on defect size: lesions below roughly 1.5–2 cm² suit single-stage surgery, those of 2–4 cm² permit either approach, and larger defects typically require tissue replacement rather than repair.Cartilage repair decisions hinge on defect size: lesions below roughly 1.5–2 cm² suit single-stage surgery, those of 2–4 cm² permit either approach, and larger defects typically require tissue replacement rather than repair.
When cartilage repair is the right choiceCartilage repair succeeds for a focal defect in otherwise healthy joint tissue in younger patients, but fails in diffuse arthritis. Lesion size, depth, patient age, and activity level determine the appropriate technique.Cartilage repair succeeds for a focal defect in otherwise healthy joint tissue in younger patients, but fails in diffuse arthritis. Lesion size, depth, patient age, and activity level determine the appropriate technique.
How ACI and MACI differ for cartilage repairMACI pre-seeds cultured chondrocytes onto a collagen membrane fixed with fibrin glue, eliminating the sutures required in earlier ACI variants. The technique enables arthroscopic implantation and supports faster recovery than open surgical approaches.MACI pre-seeds cultured chondrocytes onto a collagen membrane fixed with fibrin glue, eliminating the sutures required in earlier ACI variants. The technique enables arthroscopic implantation and supports faster recovery than open surgical approaches.
When is it too late for cartilage repair?Once cartilage loss becomes generalised and surfaces contact bone, no restoration procedure works; repair is viable only for focal defects.Once cartilage loss becomes generalised and surfaces contact bone, no restoration procedure works; repair is viable only for focal defects.