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Single-stage vs two-stage ACI for cartilage repairTraditional two-stage ACI involves two general anaesthetics separated by a four-to-six-week cell culture period; STACI performs both stages in a single theatre session, requiring one general anaesthetic and eliminating the inter-stage gap.Traditional two-stage ACI involves two general anaesthetics separated by a four-to-six-week cell culture period; STACI performs both stages in a single theatre session, requiring one general anaesthetic and eliminating the inter-stage gap.
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How defect size and age decide OATS or OCADefect size determines whether focal cartilage repair uses autograft (OATS, harvested from the patient's own knee) or donor allograft (OCA): below 2 cm², autograft is viable; above 4 cm², only allograft remains before arthroplasty.Defect size determines whether focal cartilage repair uses autograft (OATS, harvested from the patient's own knee) or donor allograft (OCA): below 2 cm², autograft is viable; above 4 cm², only allograft remains before arthroplasty.
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Is OATS knee surgery worth itCartilage damage beyond a certain point cannot self-repair. OATS transplants healthy cartilage plugs to replace it, with 85–93% achieving clinical success and improvements sustained at ten and twenty years, though 10–15% experience persistent donor-site pain.Cartilage damage beyond a certain point cannot self-repair. OATS transplants healthy cartilage plugs to replace it, with 85–93% achieving clinical success and improvements sustained at ten and twenty years, though 10–15% experience persistent donor-site pain.
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AMIC versus MACI for focal cartilage repairAMIC repairs focal cartilage defects in one operation: drilling channels into damaged cartilage releases a blood clot rich in stem cells, which a collagen membrane then stabilises and concentrates to guide tissue repair. A 2025 trial found it equivalent to MACI at two years.AMIC repairs focal cartilage defects in one operation: drilling channels into damaged cartilage releases a blood clot rich in stem cells, which a collagen membrane then stabilises and concentrates to guide tissue repair. A 2025 trial found it equivalent to MACI at two years.
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Do you need a knee or ankle cartilage specialistPersistent knee or ankle pain, swelling or loss of function despite simple self-care usually warrants orthopaedic assessment; a cartilage or joint-preservation specialist is most useful when MRI shows a focal defect in a relatively healthy joint, while diffuse wear-and-tear or advanced arthritis usually suits a general orthopaedic or sports surgeon.Persistent knee or ankle pain, swelling or loss of function despite simple self-care usually warrants orthopaedic assessment; a cartilage or joint-preservation specialist is most useful when MRI shows a focal defect in a relatively healthy joint, while diffuse wear-and-tear or advanced arthritis usually suits a general orthopaedic or sports surgeon.
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Choosing cartilage repair pathways for knee and ankleSmall focal cartilage defects in the knee and ankle are treated differently from diffuse arthritis: first with physiotherapy and symptom control, then with repair procedures such as microfracture for lesions under about 1.0 cm², scaffold augmentation for larger defects, and OATS or osteochondral allograft for bigger or cystic lesions.Small focal cartilage defects in the knee and ankle are treated differently from diffuse arthritis: first with physiotherapy and symptom control, then with repair procedures such as microfracture for lesions under about 1.0 cm², scaffold augmentation for larger defects, and OATS or osteochondral allograft for bigger or cystic lesions.
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Can chondroplasty or an unloader brace helpChondroplasty trims and smooths damaged knee cartilage to ease catching and irritation, but it does not regrow cartilage; outcomes are best in isolated grade 2 to 3 lesions, not grade 4 disease. An unloader brace can reduce one-compartment load and pain when varus or valgus malalignment is driving symptoms, but…Chondroplasty trims and smooths damaged knee cartilage to ease catching and irritation, but it does not regrow cartilage; outcomes are best in isolated grade 2 to 3 lesions, not grade 4 disease. An unloader brace can reduce one-compartment load and pain when varus or valgus malalignment is driving symptoms, but it cannot correct alignment.
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Which knee cartilage repair fits your situationKnee cartilage repair choice is driven by defect size, bone involvement and whether treatment is single-stage or staged. OATS or mosaicplasty uses the patient's own osteochondral plugs for small focal defects of roughly 1 to 4 cm², while OCA uses donor tissue when the defect is larger, post-traumatic or involves…Knee cartilage repair choice is driven by defect size, bone involvement and whether treatment is single-stage or staged. OATS or mosaicplasty uses the patient's own osteochondral plugs for small focal defects of roughly 1 to 4 cm², while OCA uses donor tissue when the defect is larger, post-traumatic or involves significant bone loss. AMIC is a single-stage marrow stimulation with a collagen membrane; MACI takes two stages but has 15- to 17-year follow-up data, while head-to-head AMIC-vs-MACI ev...
