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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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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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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...
