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OATS for Osteochondral Lesions of the TalusLesions larger than approximately 150 mm² fail bone marrow stimulation treatment 97% of the time. OATS transplants genuine hyaline cartilage to replace the weakening fibrocartilage scar that microfracture produces in larger defects.Lesions larger than approximately 150 mm² fail bone marrow stimulation treatment 97% of the time. OATS transplants genuine hyaline cartilage to replace the weakening fibrocartilage scar that microfracture produces in larger defects.
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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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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°.
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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.
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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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OATS or microfracture for active knee patientsMicrofracture improves early but deteriorates progressively beyond two years because it deposits fibrocartilage, whilst OATS transplants intact cartilage that remains stable long-term.Microfracture improves early but deteriorates progressively beyond two years because it deposits fibrocartilage, whilst OATS transplants intact cartilage that remains stable long-term.
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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.
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Chondroplasty for knee cartilage damageChondroplasty removes loose cartilage fragments that cause catching and grinding, relieving mechanical symptoms, but does not rebuild the cartilage itself; it is palliative, not restorative.Chondroplasty removes loose cartilage fragments that cause catching and grinding, relieving mechanical symptoms, but does not rebuild the cartilage itself; it is palliative, not restorative.
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Who benefits from an unloader knee braceUnloader braces use three-point pressure to shift load away from damaged cartilage. They work only for single-compartment osteoarthritis, and success depends more on professional fitting and follow-up than the device itself.Unloader braces use three-point pressure to shift load away from damaged cartilage. They work only for single-compartment osteoarthritis, and success depends more on professional fitting and follow-up than the device itself.
