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Knee Cartilage Repair and PreservationArticular cartilage lacks blood vessels, so when damaged it forms fibrocartilage—a mechanically inferior scar tissue that typically deteriorates within two to three years. This biological constraint shapes every treatment option, from temporary symptom relief to procedures attempting true cartilage regeneration.Articular cartilage lacks blood vessels, so when damaged it forms fibrocartilage—a mechanically inferior scar tissue that typically deteriorates within two to three years. This biological constraint shapes every treatment option, from temporary symptom relief to procedures attempting true cartilage regeneration.
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How long osteochondral allografts lastFresh osteochondral allografts achieve approximately 82–86% graft survival at five years and roughly 70% beyond 20 years; outcomes depend substantially on patient BMI, prior knee surgery, and adherence to structured post-operative support.Fresh osteochondral allografts achieve approximately 82–86% graft survival at five years and roughly 70% beyond 20 years; outcomes depend substantially on patient BMI, prior knee surgery, and adherence to structured post-operative support.
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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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ChondroFiller injection versus knee replacement for focal defectsChondroFiller, a gelling collagen scaffold that recruits the patient's own cells to repair cartilage, suits isolated focal defects; knee replacement addresses widespread multi-compartment osteoarthritis.ChondroFiller, a gelling collagen scaffold that recruits the patient's own cells to repair cartilage, suits isolated focal defects; knee replacement addresses widespread multi-compartment osteoarthritis.
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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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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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Who qualifies for OATS knee surgeryOATS transplants hyaline cartilage harvested from a low-load zone of the same knee to repair focal defects. The donor site heals with fibrocartilage, creating potential for catching, locking, or anterior knee pain.OATS transplants hyaline cartilage harvested from a low-load zone of the same knee to repair focal defects. The donor site heals with fibrocartilage, creating potential for catching, locking, or anterior knee pain.
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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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Allograft or Autograft for Large Knee Cartilage DefectsDefect size is the primary determinant in knee cartilage repair: below 4 cm², autograft transfer from low-load zones is standard; above that threshold, cadaveric allograft removes the biological supply ceiling.Defect size is the primary determinant in knee cartilage repair: below 4 cm², autograft transfer from low-load zones is standard; above that threshold, cadaveric allograft removes the biological supply ceiling.
