Cartilage repair Mesa: a graft fits only certain joint damage

A graft may fit one clear area of damage

A surgeon measures the damaged cartilage and checks whether the bone below can hold a graft. Ligaments, the strong bands holding the knee together, must keep it steady. The meniscus, a rubbery pad between the knee bones, must still spread weight well. The surgeon also checks whether your leg puts too much weight on one side of the knee.

Broad wear is usually a poor match for a small graft, while an earlier operation may also limit the choices.

What happens at the visit? You will be asked when the trouble began and which movements hurt. The exam checks swelling, bending, muscle strength, and tender areas. The scan is then compared with the sore areas found during that exam.

A QC Kinetix consultation is with medical providers, so a doctor or another licensed clinician reviews your health and examines the joint.

Some symptoms need prompt medical care

Heat and swelling in a joint, along with fever, can mean an infection. Get prompt medical care. After an injury, get help if you can't stand on the leg or straighten the joint. Sudden locking, new weakness, or swelling that rises quickly also needs attention.

Don't wait for a routine appointment with those symptoms.

Soreness that builds slowly is less urgent. Arrange a visit when it keeps you from sleeping or walking. Bring old reports and details about past operations. Explain which daily task you want to do with less soreness.

The visit may lead to home care, a non-surgical option, or a surgeon's opinion. It may also show that no new treatment is needed now.

A safe answer sometimes means waiting and watching.

Sources

1. A JBJS evidence-based review of chondral lesions of the knee sets management by lesion size, location, limb alignment and rotation, and patient demand rather than by product: osteochondral autograft transfer is described as durable and predictable for smaller lesions (under 2 cm2) in young active patients, while lesions of 2 cm2 or more are typically treated with osteochondral allograft transplantation, particulated juvenile articular cartilage, or matrix-associated chondrocyte implantation, with favourable mid- and long-term results reported for allograft or MACI in large lesions of 3 cm2 or more.

   Dekker TJ, et al. — Chondral Lesions of the Knee: An Evidence-Based Approach.. J Bone Joint Surg Am, 2021. DOI: 10.2106/JBJS.20.01161.

2. In a meta-analysis of 63 studies covering 5,397 knees of 4,751 adults with NO symptoms and no injury, the pooled prevalence of cartilage defects on MRI was 24% (95% CI 15% to 34%), rising from 11% in adults under 40 to 43% in adults aged 40 and over. Meniscal tears were present in 10%, bone marrow lesions in 18% and osteophytes in 25%.

   Culvenor AG, et al. — Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis.. Br J Sports Med, 2019. DOI: 10.1136/bjsports-2018-099257.

3. In six studies covering 349 patients who received an osteochondral allograft AFTER a failed index cartilage procedure - 73.8% of them marrow stimulation - the mean defect at revision measured 5.8 cm2 (range 4.0 to 9.5) and the overall failure rate after the salvage allograft was 16.6%. A failed first procedure usually means a bigger, harder second one.

   Gopinatth V, et al. — Osteochondral Allograft Transplantation as a Salvage Procedure After Failed Index Cartilage Surgery of the Knee: A Systematic Review.. Am J Sports Med, 2025. DOI: 10.1177/03635465241238466.

4. A contemporary systematic review of 52 studies (2,387 athletes) found pooled return to sport of 80.3% (95% CI 73.3% to 86.5%) after knee cartilage restoration. MACI (OR 2.15) and osteochondral autograft (OR 1.83) had the highest odds of returning at the same or a higher level of play, while microfracture was the ONLY treatment associated with returning at a lower level (OR 0.78). The fastest mean return was after osteochondral autograft at 6.6 months.

   Kunze KN, et al. — High Rate of Return to Sport for Athletes Undergoing Articular Cartilage Restoration Procedures for the Knee: A Systematic Review of Contemporary Studies.. Am J Sports Med, 2025. DOI: 10.1177/03635465241280975.

5. A 251-patient multicentre randomised trial deliberately enrolled knees with concurrent mild to moderate osteoarthritis (Kellgren-Lawrence 0-3) alongside focal defects of 1 to 7 cm2. An aragonite-based osteochondral implant beat arthroscopic debridement and microfracture on the primary endpoint and every secondary endpoint: 77.8% versus 33.6% responders at two years, at least 75% MRI defect fill in 88.5% versus 30.9%, and failure in 7.2% versus 21.4%.

   Altschuler N, et al. — Aragonite-Based Scaffold Versus Microfracture and Debridement for the Treatment of Knee Chondral and Osteochondral Lesions: Results of a Multicenter Randomized Controlled Trial.. Am J Sports Med, 2023. DOI: 10.1177/03635465231151252.