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Cartilage specialist or general orthopaedic surgeon for a knee defectKnee cartilage repair without correcting underlying malalignment results in reoperation in 47.4% of cases, versus 17.3% when alignment is corrected simultaneously — a surgical integration that general orthopaedic surgeons often omit from initial assessment and planning.Knee cartilage repair without correcting underlying malalignment results in reoperation in 47.4% of cases, versus 17.3% when alignment is corrected simultaneously — a surgical integration that general orthopaedic surgeons often omit from initial assessment and planning.
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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.
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When cartilage repair is the right choiceCartilage repair is only for younger, active patients with small focal defects who can sustain nine to eighteen months of intensive rehabilitation.Cartilage repair is only for younger, active patients with small focal defects who can sustain nine to eighteen months of intensive rehabilitation.
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OATS versus osteochondral allograft for large knee defectsDefect size determines which procedure: OATS, harvesting cartilage plugs from the patient's own knee, suits lesions up to 4 cm²; osteochondral allograft, using donor tissue, handles larger defects without an equivalent size limit.Defect size determines which procedure: OATS, harvesting cartilage plugs from the patient's own knee, suits lesions up to 4 cm²; osteochondral allograft, using donor tissue, handles larger defects without an equivalent size limit.
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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.
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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.
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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.
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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.
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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.
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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.
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OATS versus mosaicplasty for knee cartilage repairOATS and mosaicplasty are the same surgical technique applied at different scales: OATS transfers a single cartilage plug for knee defects under 2 cm², mosaicplasty tiles smaller grafts across 2–4 cm² lesions.OATS and mosaicplasty are the same surgical technique applied at different scales: OATS transfers a single cartilage plug for knee defects under 2 cm², mosaicplasty tiles smaller grafts across 2–4 cm² lesions.
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Osteochondral Allograft for Post-Traumatic Knee DefectsWhen post-traumatic knee injury damages both cartilage and underlying bone, osteochondral allograft transplants provide a single-stage solution that other repair methods cannot match. Roughly 75–82% of patients return to sport; grafts show 87% survival at five years, declining to 68% at twenty.When post-traumatic knee injury damages both cartilage and underlying bone, osteochondral allograft transplants provide a single-stage solution that other repair methods cannot match. Roughly 75–82% of patients return to sport; grafts show 87% survival at five years, declining to 68% at twenty.
