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AMIC vs MACI for knee cartilage repairStandalone microfracture for knee cartilage defects has less than 60% survivorship at three years; AMIC adds a collagen membrane to stabilize repair, whilst MACI uses cultured chondrocytes and shows superiority in the SUMMIT trial for lesions over 3 cm².Standalone microfracture for knee cartilage defects has less than 60% survivorship at three years; AMIC adds a collagen membrane to stabilize repair, whilst MACI uses cultured chondrocytes and shows superiority in the SUMMIT trial for lesions over 3 cm².
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Cartilage Specialist or General Orthopaedic SurgeonFocal cartilage damage—treated with progressive repair techniques from injections to cell-based therapy—warrants a cartilage specialist. Widespread arthritis, fractures, or joint replacement require a general orthopaedic surgeon. Damage type and location, not pain severity, determine which specialist is appropriate.Focal cartilage damage—treated with progressive repair techniques from injections to cell-based therapy—warrants a cartilage specialist. Widespread arthritis, fractures, or joint replacement require a general orthopaedic surgeon. Damage type and location, not pain severity, determine which specialist is appropriate.
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MACI versus microfracture for knee cartilage repairMACI outperforms microfracture for knee cartilage defects of 3 cm² or larger, according to the SUMMIT randomised trial, which found significantly greater improvements in pain and function at two years that persisted through five years.MACI outperforms microfracture for knee cartilage defects of 3 cm² or larger, according to the SUMMIT randomised trial, which found significantly greater improvements in pain and function at two years that persisted through five years.
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AMIC vs microfracture for knee cartilage repairBoth AMIC and microfracture improve pain and function in the first two years; beyond that point, microfracture outcomes progressively deteriorate whilst AMIC maintains stable gains through a decade of follow-up.Both AMIC and microfracture improve pain and function in the first two years; beyond that point, microfracture outcomes progressively deteriorate whilst AMIC maintains stable gains through a decade of follow-up.
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MACI vs Microfracture for Knee Cartilage RepairFor focal knee cartilage defects above 3 cm², MACI outperformed microfracture across all clinical measures: pain scores improved to 82.5 versus 70.9 at two years, with durability sustained at five-year follow-up.For focal knee cartilage defects above 3 cm², MACI outperformed microfracture across all clinical measures: pain scores improved to 82.5 versus 70.9 at two years, with durability sustained at five-year follow-up.
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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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OATS for focal knee cartilage repair in active patientsSingle-stage transplantation of cartilage plugs from the patient's own knee achieves 8.4-year mean functional survival in younger active patients — nearly double microfracture repair — with 75–93% returning to pre-injury sport within six to nine months.Single-stage transplantation of cartilage plugs from the patient's own knee achieves 8.4-year mean functional survival in younger active patients — nearly double microfracture repair — with 75–93% returning to pre-injury sport within six to nine months.
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Choosing joint preserving surgery before knee replacementOne-compartment knee wear does not automatically mean replacement is next: bracing, osteotomy and focal cartilage repair can reduce pain and delay arthroplasty when alignment and damage remain localised. Microfracture is now usually limited to very small defects, while AMIC, MACI, OATS and OCA are chosen by lesion size, depth and…One-compartment knee wear does not automatically mean replacement is next: bracing, osteotomy and focal cartilage repair can reduce pain and delay arthroplasty when alignment and damage remain localised. Microfracture is now usually limited to very small defects, while AMIC, MACI, OATS and OCA are chosen by lesion size, depth and joint health.
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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.
