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When knee pain needs an orthopaedic assessmentMost knee pain settles with rest and physiotherapy; the threshold for orthopaedic assessment is persistent dysfunction despite weeks of conservative care, or acute structural changes—and assessment maps options rather than commits to surgery.Most knee pain settles with rest and physiotherapy; the threshold for orthopaedic assessment is persistent dysfunction despite weeks of conservative care, or acute structural changes—and assessment maps options rather than commits to surgery.
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High tibial osteotomy as a first step in knee preservationHigh tibial osteotomy repositions the tibia to shift weight-bearing from damaged inner knee cartilage to the healthier outer compartment. For younger, active patients, the procedure preserves the natural joint and potentially extends its working life by a decade or more.High tibial osteotomy repositions the tibia to shift weight-bearing from damaged inner knee cartilage to the healthier outer compartment. For younger, active patients, the procedure preserves the natural joint and potentially extends its working life by a decade or more.
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Knee cartilage repair versus stem cell therapyEstablished cartilage repair using autologous chondrocytes shows 10–17 year durability for focal knee defects; mesenchymal stem cell therapies have not been tested in large-scale trials against them.Established cartilage repair using autologous chondrocytes shows 10–17 year durability for focal knee defects; mesenchymal stem cell therapies have not been tested in large-scale trials against them.
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ChondroFiller™ durability compared with ArthrosamidChondroFiller™ recruits the patient's own progenitor cells to build new cartilage tissue within a collagen scaffold. Three-year published follow-up shows mean IKDC scores of 80 — a 32.4-point improvement from baseline — with durability reported to extend beyond five years.ChondroFiller™ recruits the patient's own progenitor cells to build new cartilage tissue within a collagen scaffold. Three-year published follow-up shows mean IKDC scores of 80 — a 32.4-point improvement from baseline — with durability reported to extend beyond five years.
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Medial knee pain that isn't a meniscus tearAround 850,000 meniscal surgeries are performed annually in the United States, yet five other structures in the medial knee generate pain so similar that clinicians commonly mistake them for meniscal tears.Around 850,000 meniscal surgeries are performed annually in the United States, yet five other structures in the medial knee generate pain so similar that clinicians commonly mistake them for meniscal tears.
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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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OCA vs MACI for large knee cartilage defectsMACI (matrix-induced autologous chondrocyte implantation) is a surface repair requiring intact subchondral bone; osteochondral allograft (OCA) replaces both cartilage and bone. When knee cartilage defects breach underlying bone, OCA addresses what MACI cannot.MACI (matrix-induced autologous chondrocyte implantation) is a surface repair requiring intact subchondral bone; osteochondral allograft (OCA) replaces both cartilage and bone. When knee cartilage defects breach underlying bone, OCA addresses what MACI cannot.
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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.
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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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Cartilage repair or knee replacementThe choice between cartilage repair and knee replacement hinges on whether damage is focal or diffuse. Isolated defects in otherwise healthy joints can be repaired; widespread bone-on-bone osteoarthritis affecting multiple compartments requires replacement instead.The choice between cartilage repair and knee replacement hinges on whether damage is focal or diffuse. Isolated defects in otherwise healthy joints can be repaired; widespread bone-on-bone osteoarthritis affecting multiple compartments requires replacement instead.
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ChondroFiller duration vs hyaluronic acid and ArthrosamidChondroFiller's repair tissue outlasts the scaffold itself: the collagen dissolves within two years, but tissue built by the patient's own progenitor cells persists for three to five years.ChondroFiller's repair tissue outlasts the scaffold itself: the collagen dissolves within two years, but tissue built by the patient's own progenitor cells persists for three to five years.
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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°.
