Level I RCT (n=80) comparing ACI versus microfracture for single chronic symptomatic femoral condyle cartilage defects at five years. Outcomes measured include Lysholm, VAS pain, SF-36, Tegner, and Kellgren-Lawrence radiographic grading.
For isolated femoral condyle cartilage defects, microfracture is as effective as ACI at five years and should be the first-line procedure — reserve ACI for large, uncontained defects or after microfracture failure.
Counsel all patients that 23% failure rates and early radiographic OA in one-third are realistic five-year expectations regardless of technique, and that age under 30 is the strongest predictor of a good outcome.
Level I RCT (n=80) comparing ACI versus microfracture for single chronic symptomatic femoral condyle cartilage defects at five years. Outcomes measured include Lysholm, VAS pain, SF-36, Tegner, and Kellgren-Lawrence radiographic grading.
For isolated femoral condyle cartilage defects, microfracture is as effective as ACI at five years and should be the first-line procedure — reserve ACI for large, uncontained defects or after microfracture failure.
Counsel all patients that 23% failure rates and early radiographic OA in one-third are realistic five-year expectations regardless of technique, and that age under 30 is the strongest predictor of a good outcome.