:format(webp)/cdn.mskdoctors.com/storage/2026/7/8c3WGhTDSa50H5g1A54m11iCswgvY7B4.jpg)
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.
:format(webp)/cdn.mskdoctors.com/storage/2026/7/kmMxPuMwu9egb4OdtoM6MP7cn9CjTQ4c.jpg)
When knee cartilage repair is worth consideringCartilage lacks a blood supply and cannot self-heal, but surgical or minimally invasive repair can restore focal defects in otherwise healthy joints, potentially delaying knee replacement by years or decades.Cartilage lacks a blood supply and cannot self-heal, but surgical or minimally invasive repair can restore focal defects in otherwise healthy joints, potentially delaying knee replacement by years or decades.
:format(webp)/cdn.mskdoctors.com/storage/2026/7/O9hRQN3MyIy3jy3fr4jwrOPrMUBepqDK.jpg)
The cost of leaving a knee cartilage defect untreatedKnee cartilage defects do not heal because cartilage lacks blood supply; defects widen under load with each step, spreading damage to surrounding tissue and progressing towards osteoarthritis if untreated.Knee cartilage defects do not heal because cartilage lacks blood supply; defects widen under load with each step, spreading damage to surrounding tissue and progressing towards osteoarthritis if untreated.
:format(webp)/cdn.mskdoctors.com/storage/2026/7/8Ybarca5EyikHWwPNDgHdzL8O444HHna.jpg)
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.
:format(webp)/cdn.mskdoctors.com/storage/2026/7/74YTQQTyjHqGW0SCQyz2DVitXQ2VE6a3.jpg)
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.
:format(webp)/cdn.mskdoctors.com/storage/2026/7/jMuW71JG09Hn3XswSLdJTLmPIdl4VfER.jpg)
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.
:format(webp)/cdn.mskdoctors.com/storage/2026/7/9OiobpkziAwYG429O5Dmiz2cAtSHRBCc.jpg)
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.
:format(webp)/cdn.mskdoctors.com/storage/2026/7/ThhdXZ4jszzV06FAmL90Dnfs5PFnrs4D.jpg)
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.
:format(webp)/cdn.mskdoctors.com/storage/2026/7/YjVRrObruXhFRSj4s2XzPrviUN6lGG71.jpg)
Cartilage Specialist or General Orthopaedic SurgeonFocal cartilage damage—treated with progressive repair techniques from injections to cell-based therapy—warrants a cartilage specialist. Widespread arthritis, fractures, or joint replacement require a general orthopaedic surgeon. Damage type and location, not pain severity, determine which specialist is appropriate.Focal cartilage damage—treated with progressive repair techniques from injections to cell-based therapy—warrants a cartilage specialist. Widespread arthritis, fractures, or joint replacement require a general orthopaedic surgeon. Damage type and location, not pain severity, determine which specialist is appropriate.
:format(webp)/cdn.mskdoctors.com/storage/2026/7/gsAUDRVQLunD0FcY4ym5CZ9Bm37CFOyy.jpg)
When cartilage repair makes sense before knee replacementTotal knee replacement achieves over 90% long-term success, yet patients under 55 face substantially higher revision risk within 20 years. For focal cartilage damage in the mid-40s, repair offers a joint-preservation pathway suited to this earlier disease stage—provided defect size and patient profile meet defined clinical criteria.Total knee replacement achieves over 90% long-term success, yet patients under 55 face substantially higher revision risk within 20 years. For focal cartilage damage in the mid-40s, repair offers a joint-preservation pathway suited to this earlier disease stage—provided defect size and patient profile meet defined clinical criteria.
:format(webp)/cdn.mskdoctors.com/storage/2026/7/J20dyyiCwCNYJA27kKufzruIBZeitWiP.jpg)
OCA or MACI for large knee cartilage defectsWhen subchondral bone is damaged alongside large knee cartilage defects, OCA — a single-stage transplant of donor bone and cartilage — is the preferred choice; MACI, which implants cultured cells, cannot restore bone stock once lost.When subchondral bone is damaged alongside large knee cartilage defects, OCA — a single-stage transplant of donor bone and cartilage — is the preferred choice; MACI, which implants cultured cells, cannot restore bone stock once lost.
:format(webp)/cdn.mskdoctors.com/storage/2026/7/jsvrgfCOH4IBtCsmXXnshr2LWJGubdnf.jpg)
MACI versus microfracture for knee cartilage repairMACI outperforms microfracture for knee cartilage defects of 3 cm² or larger, according to the SUMMIT randomised trial, which found significantly greater improvements in pain and function at two years that persisted through five years.MACI outperforms microfracture for knee cartilage defects of 3 cm² or larger, according to the SUMMIT randomised trial, which found significantly greater improvements in pain and function at two years that persisted through five years.
