:format(webp)/cdn.mskdoctors.com/storage/2026/8/eDBqkRJ5A1r3cEbE6i9pXLmSRpW9KXTA.jpg)
ACI versus MACI for Knee Cartilage RepairMACI seeds cultured cartilage cells onto a porcine-collagen scaffold fixed with fibrin glue; ACI injects them as liquid suspension sealed with a sutured flap. This mechanical difference determines recovery time, complication risk, and surgical complexity.MACI seeds cultured cartilage cells onto a porcine-collagen scaffold fixed with fibrin glue; ACI injects them as liquid suspension sealed with a sutured flap. This mechanical difference determines recovery time, complication risk, and surgical complexity.
:format(webp)/cdn.mskdoctors.com/storage/2026/8/JRFtBp0mcZmXZbOaQOz1rXHk9oX5RoWx.jpg)
Knee cartilage damage left untreated and when repair helpsCartilage lacks blood vessels, nerve fibres, and lymph channels, so repair cells cannot reach injuries and pain does not warn of damage, allowing lesions to expand silently until they become clinically serious.Cartilage lacks blood vessels, nerve fibres, and lymph channels, so repair cells cannot reach injuries and pain does not warn of damage, allowing lesions to expand silently until they become clinically serious.
:format(webp)/cdn.mskdoctors.com/storage/2026/8/1kostbLohg0wwytoKJl2x8K1M3SKeLa9.jpg)
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.
:format(webp)/cdn.mskdoctors.com/storage/2026/7/LIOvsXTYshmGCUaPXjDSuxONuPPfG12x.jpg)
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.
: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.
:format(webp)/cdn.mskdoctors.com/storage/2026/7/ZxrFplLqik6Q3f66pfQogigyqEsWsha8.jpg)
ACI vs MACI for knee cartilage repairMACI seeds harvested chondrocytes onto a collagen membrane secured with fibrin glue; first-generation ACI injects them as a liquid suspension under a sutured periosteal patch. This engineering difference has driven MACI's adoption: complication rates of approximately 10% versus 29%, with superior pain reduction and activity levels.MACI seeds harvested chondrocytes onto a collagen membrane secured with fibrin glue; first-generation ACI injects them as a liquid suspension under a sutured periosteal patch. This engineering difference has driven MACI's adoption: complication rates of approximately 10% versus 29%, with superior pain reduction and activity levels.
:format(webp)/cdn.mskdoctors.com/storage/2026/6/KjpMHrbjL20lkYbuDX3KR2dJ4SZiKdyx.jpg)
MACI vs Microfracture for Knee Cartilage RepairFor focal knee cartilage defects above 3 cm², MACI outperformed microfracture across all clinical measures: pain scores improved to 82.5 versus 70.9 at two years, with durability sustained at five-year follow-up.For focal knee cartilage defects above 3 cm², MACI outperformed microfracture across all clinical measures: pain scores improved to 82.5 versus 70.9 at two years, with durability sustained at five-year follow-up.
:format(webp)/cdn.mskdoctors.com/storage/2026/6/noSAeN4a2BSC0Xti4RlZr7R5GcLNDLgg.jpg)
STACi vs MACI for knee cartilage repairSTACi performs knee cartilage repair in one operation by combining bone-marrow stem cells with patient chondrocytes on a three-dimensional scaffold — differing from MACI in cell composition and scaffold structure, though lacking randomised-trial evidence for long-term durability.STACi performs knee cartilage repair in one operation by combining bone-marrow stem cells with patient chondrocytes on a three-dimensional scaffold — differing from MACI in cell composition and scaffold structure, though lacking randomised-trial evidence for long-term durability.
:format(webp)/cdn.mskdoctors.com/storage/2026/6/C7DDfi2PE3ql14IEDxaKbdyXemQ7V80V.jpg)
ACI vs MACI for knee cartilage repairBoth ACI and MACI for knee cartilage repair follow a two-stage structure: cartilage biopsy with laboratory expansion, then implantation. The difference lies in the second stage's delivery mechanism—ACI injects expanded cells beneath a periosteal patch, while MACI pre-seeds them onto a collagen membrane secured with fibrin glue.Both ACI and MACI for knee cartilage repair follow a two-stage structure: cartilage biopsy with laboratory expansion, then implantation. The difference lies in the second stage's delivery mechanism—ACI injects expanded cells beneath a periosteal patch, while MACI pre-seeds them onto a collagen membrane secured with fibrin glue.
:format(webp)/cdn.mskdoctors.com/storage/2026/6/V8pC3D5lUrSGaTz86UuCtKDuj87N5s5p.jpg)
OATS and Mosaicplasty for Knee Cartilage RepairOATS delivers genuine hyaline cartilage — the knee's native resilient material — to repair focal defects in one operation; marrow-stimulation techniques like microfracture instead produce fibrocartilage, scar-like tissue that begins to break down within two to three years under athletic demand.OATS delivers genuine hyaline cartilage — the knee's native resilient material — to repair focal defects in one operation; marrow-stimulation techniques like microfracture instead produce fibrocartilage, scar-like tissue that begins to break down within two to three years under athletic demand.
:format(webp)/cdn.mskdoctors.com/storage/2026/6/jzYk9Tv2c8Ykqg6IOjEKiYr6Q35JJsYb.jpg)
When Knee Alignment Must Come Before Cartilage RepairCartilage repair fails in a varus knee because the weight-bearing line runs through the damaged medial compartment instead of the joint's centre. High tibial osteotomy redirects that line toward the centre; expert guidance mandates combined surgery above 3° varus and forbids isolated repair beyond 5°.Cartilage repair fails in a varus knee because the weight-bearing line runs through the damaged medial compartment instead of the joint's centre. High tibial osteotomy redirects that line toward the centre; expert guidance mandates combined surgery above 3° varus and forbids isolated repair beyond 5°.
:format(webp)/cdn.mskdoctors.com/storage/2026/6/Ve9V5o28ujztizkD5TuIOycurhx13Uwl.jpg)
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.
