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.
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.
ChondroFiller IKDC and MOCART scoresChondroFiller patients' functional-outcome scores (IKDC) gain approximately 30 points within 12 months, rising from ~48 to ~80, whilst structural MRI (MOCART) markers advance from 65 to 81–84 — dual tracks converging on tissue repair and restored joint function.ChondroFiller patients' functional-outcome scores (IKDC) gain approximately 30 points within 12 months, rising from ~48 to ~80, whilst structural MRI (MOCART) markers advance from 65 to 81–84 — dual tracks converging on tissue repair and restored joint function.
OCA or MACI for large knee cartilage defectsWhen subchondral bone is damaged alongside large knee cartilage defects, OCA — a single-stage transplant of donor bone and cartilage — is the preferred choice; MACI, which implants cultured cells, cannot restore bone stock once lost.When subchondral bone is damaged alongside large knee cartilage defects, OCA — a single-stage transplant of donor bone and cartilage — is the preferred choice; MACI, which implants cultured cells, cannot restore bone stock once lost.
ChondroFiller NHS status and private access in the UKChondroFiller, an ultrasound-guided collagen scaffold that improves IKDC knee scores by roughly 30 points over 12 months, is unavailable on the NHS not for safety reasons but because it has not undergone formal commissioning appraisal. Private UK access costs £3,000–£9,500.ChondroFiller, an ultrasound-guided collagen scaffold that improves IKDC knee scores by roughly 30 points over 12 months, is unavailable on the NHS not for safety reasons but because it has not undergone formal commissioning appraisal. Private UK access costs £3,000–£9,500.
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.
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.
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°.
Distal femoral osteotomy for lateral knee cartilage damageKnock-kneed alignment directs excessive load through the outer knee compartment, accelerating cartilage wear over time. Distal femoral osteotomy corrects this by adjusting the lower thighbone angle to redistribute load and allow the damaged cartilage to survive or heal.Knock-kneed alignment directs excessive load through the outer knee compartment, accelerating cartilage wear over time. Distal femoral osteotomy corrects this by adjusting the lower thighbone angle to redistribute load and allow the damaged cartilage to survive or heal.
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.
Allograft vs autograft for large knee cartilage defectsAutograft for knee cartilage defects larger than roughly 2–4 cm² risks replacing one area of cartilage loss with another at the harvest site. Osteochondral allografts from cadaveric donors eliminate this trade-off and achieve 5-year survival of 79–87.8%.Autograft for knee cartilage defects larger than roughly 2–4 cm² risks replacing one area of cartilage loss with another at the harvest site. Osteochondral allografts from cadaveric donors eliminate this trade-off and achieve 5-year survival of 79–87.8%.
ChondroFiller injection vs knee replacementChondroFiller is a collagen scaffold injection that recruits the patient's own repair cells to treat focal cartilage defects. Knee replacement suits end-stage, widespread wear; the choice between them depends on imaging findings, not age.ChondroFiller is a collagen scaffold injection that recruits the patient's own repair cells to treat focal cartilage defects. Knee replacement suits end-stage, widespread wear; the choice between them depends on imaging findings, not age.