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ChondroFiller injection versus cartilage surgeryChondroFiller injection achieves 30 IKDC improvement with 3–8% reoperation and 0% complications; microfracture carries 41% reoperation rates with declining long-term outcomes; ACI/MACI matches functional gains but brings 17% complications and 37% reoperation.ChondroFiller injection achieves 30 IKDC improvement with 3–8% reoperation and 0% complications; microfracture carries 41% reoperation rates with declining long-term outcomes; ACI/MACI matches functional gains but brings 17% complications and 37% reoperation.
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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.
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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.
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Single-stage or two-stage cartilage repairCartilage repair decisions hinge on defect size: lesions below roughly 1.5–2 cm² suit single-stage surgery, those of 2–4 cm² permit either approach, and larger defects typically require tissue replacement rather than repair.Cartilage repair decisions hinge on defect size: lesions below roughly 1.5–2 cm² suit single-stage surgery, those of 2–4 cm² permit either approach, and larger defects typically require tissue replacement rather than repair.
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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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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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When OATS mosaicplasty beats other ankle cartilage repairsLesions exceeding 150 mm² require OATS mosaicplasty: marrow stimulation produces fibrocartilage that breaks down within two to three years, whilst transplanted hyaline cartilage lasts decades.Lesions exceeding 150 mm² require OATS mosaicplasty: marrow stimulation produces fibrocartilage that breaks down within two to three years, whilst transplanted hyaline cartilage lasts decades.
