:format(webp)/cdn.mskdoctors.com/storage/2026/7/p4I1DcXLxDW182tvBqgfJmV1W71YblUh.jpg)
OCA vs MACI for large knee cartilage defectsMACI (matrix-induced autologous chondrocyte implantation) is a surface repair requiring intact subchondral bone; osteochondral allograft (OCA) replaces both cartilage and bone. When knee cartilage defects breach underlying bone, OCA addresses what MACI cannot.MACI (matrix-induced autologous chondrocyte implantation) is a surface repair requiring intact subchondral bone; osteochondral allograft (OCA) replaces both cartilage and bone. When knee cartilage defects breach underlying bone, OCA addresses what MACI cannot.
:format(webp)/cdn.mskdoctors.com/storage/2026/7/jMuW71JG09Hn3XswSLdJTLmPIdl4VfER.jpg)
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.
:format(webp)/cdn.mskdoctors.com/storage/2026/7/is8VSWfOoDsMQEW39qaqpsJTqZrnWEvp.jpg)
Osteochondral Allograft for Post-Traumatic Knee DefectsWhen post-traumatic knee injury damages both cartilage and underlying bone, osteochondral allograft transplants provide a single-stage solution that other repair methods cannot match. Roughly 75–82% of patients return to sport; grafts show 87% survival at five years, declining to 68% at twenty.When post-traumatic knee injury damages both cartilage and underlying bone, osteochondral allograft transplants provide a single-stage solution that other repair methods cannot match. Roughly 75–82% of patients return to sport; grafts show 87% survival at five years, declining to 68% at twenty.
:format(webp)/cdn.mskdoctors.com/storage/2026/6/IOwceFf4oJV6LGu07zn2C2U0Dtu8LkXJ.jpg)
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.
:format(webp)/cdn.mskdoctors.com/storage/2026/6/6QeiHYD6OOnK5bpUeZbD7461HJ3zejvj.jpg)
Osteochondral Allograft for Ankle Cartilage DefectsLesions on the talus larger than 15mm fail with microfracture repair; osteochondral allograft instead restores the cartilage and bone using donor tissue, achieving 85% survivorship at ten years.Lesions on the talus larger than 15mm fail with microfracture repair; osteochondral allograft instead restores the cartilage and bone using donor tissue, achieving 85% survivorship at ten years.
:format(webp)/cdn.mskdoctors.com/storage/2026/6/Ozy3c0U8mD20VpmLr7Fu6toxPaEzHnhI.jpg)
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%.
:format(webp)/cdn.mskdoctors.com/storage/2026/5/S40NzwjPoZOsdx7aWcJgo6uP9QAIFMQY.jpg)
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...
:format(webp)/cdn.mskdoctors.com/storage/2026/5/FQID0K9GNalhSrZaulaLRUs01qb3molm.jpg)
Cartilage repair or knee replacementThe first split between cartilage repair and knee replacement is whether damage is a focal defect in an otherwise intact knee or diffuse wear across the joint. Joint-preserving treatment fits localised lesions, often in younger or active patients, with alignment, meniscus status and stability shaping the plan. Smaller focal defects…The first split between cartilage repair and knee replacement is whether damage is a focal defect in an otherwise intact knee or diffuse wear across the joint. Joint-preserving treatment fits localised lesions, often in younger or active patients, with alignment, meniscus status and stability shaping the plan. Smaller focal defects under about 2 to 4 cm² may still be treated with microfracture, but the SUMMIT trial showed MACI gave better 2-year pain and function for larger defects. OCA addresse...
