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Autograft or allograft for large knee cartilage defectsKnee cartilage defects smaller than roughly 2 cm² are typically repaired with the patient's own tissue; larger defects require fresh donor grafts because the knee lacks sufficient low-load surface to harvest from safely.Knee cartilage defects smaller than roughly 2 cm² are typically repaired with the patient's own tissue; larger defects require fresh donor grafts because the knee lacks sufficient low-load surface to harvest from safely.
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Symptoms That Warrant a Cartilage SpecialistArticular cartilage cannot repair itself because it contains no blood vessels or nerves; defects exceeding approximately 1 cm in size tend to deteriorate rather than stabilise, and the window for joint-preserving intervention is finite.Articular cartilage cannot repair itself because it contains no blood vessels or nerves; defects exceeding approximately 1 cm in size tend to deteriorate rather than stabilise, and the window for joint-preserving intervention is finite.
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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.
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ChondroFiller injection after tibial plateau fractureCartilage damage from tibial plateau fractures does not repair itself, leading to progressive joint wear. ChondroFiller, a collagen scaffold injected under ultrasound, recruits the patient's own cells to generate hyaline-like repair tissue; three-year data show functional improvement of 32.4 points, exceeding the threshold for meaningful clinical benefit.Cartilage damage from tibial plateau fractures does not repair itself, leading to progressive joint wear. ChondroFiller, a collagen scaffold injected under ultrasound, recruits the patient's own cells to generate hyaline-like repair tissue; three-year data show functional improvement of 32.4 points, exceeding the threshold for meaningful clinical benefit.
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Allograft vs autograft for large knee cartilage defectsAutograft for knee cartilage defects larger than roughly 2–4 cm² risks replacing one area of cartilage loss with another at the harvest site. Osteochondral allografts from cadaveric donors eliminate this trade-off and achieve 5-year survival of 79–87.8%.Autograft for knee cartilage defects larger than roughly 2–4 cm² risks replacing one area of cartilage loss with another at the harvest site. Osteochondral allografts from cadaveric donors eliminate this trade-off and achieve 5-year survival of 79–87.8%.
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ChondroFiller injection vs knee replacementChondroFiller is a collagen scaffold injection that recruits the patient's own repair cells to treat focal cartilage defects. Knee replacement suits end-stage, widespread wear; the choice between them depends on imaging findings, not age.ChondroFiller is a collagen scaffold injection that recruits the patient's own repair cells to treat focal cartilage defects. Knee replacement suits end-stage, widespread wear; the choice between them depends on imaging findings, not age.
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Injectable scaffold vs surgical knee cartilage repairFor focal knee cartilage defects, injectable collagen scaffolds provide a non-surgical treatment by acting as an acellular matrix that guides the patient's own progenitor cells in regenerating cartilage-like tissue, overcoming cartilage's inability to repair itself due to lacking blood supply.For focal knee cartilage defects, injectable collagen scaffolds provide a non-surgical treatment by acting as an acellular matrix that guides the patient's own progenitor cells in regenerating cartilage-like tissue, overcoming cartilage's inability to repair itself due to lacking blood supply.
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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.
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OATS for focal knee cartilage repair in active patientsSingle-stage transplantation of cartilage plugs from the patient's own knee achieves 8.4-year mean functional survival in younger active patients — nearly double microfracture repair — with 75–93% returning to pre-injury sport within six to nine months.Single-stage transplantation of cartilage plugs from the patient's own knee achieves 8.4-year mean functional survival in younger active patients — nearly double microfracture repair — with 75–93% returning to pre-injury sport within six to nine months.
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Chondroplasty for knee cartilage damageChondroplasty removes loose cartilage fragments that cause catching and grinding, relieving mechanical symptoms, but does not rebuild the cartilage itself; it is palliative, not restorative.Chondroplasty removes loose cartilage fragments that cause catching and grinding, relieving mechanical symptoms, but does not rebuild the cartilage itself; it is palliative, not restorative.
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ChondroFiller success rates in practiceChondroFiller, which recruits a patient's own cells to fill cartilage defects, produces meaningful pain reduction and improved joint function in 70–85% of patients within one to five years; but success depends on selecting younger patients with focal defects in otherwise healthy joints.ChondroFiller, which recruits a patient's own cells to fill cartilage defects, produces meaningful pain reduction and improved joint function in 70–85% of patients within one to five years; but success depends on selecting younger patients with focal defects in otherwise healthy joints.
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Who benefits from an unloader knee braceUnloader braces use three-point pressure to shift load away from damaged cartilage. They work only for single-compartment osteoarthritis, and success depends more on professional fitting and follow-up than the device itself.Unloader braces use three-point pressure to shift load away from damaged cartilage. They work only for single-compartment osteoarthritis, and success depends more on professional fitting and follow-up than the device itself.
