Cartilage Injury of the Knee: Current Controversies (2021 Annual Meeting)-Cartilage Injury of the Knee: Current Controversies in 2021-Gomoll

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Video Summary

In 2021, cell-based cartilage repair offers evolving options primarily involving particulate juvenile cartilage allograft (PJEC), viable cartilage allograft, and matrix-associated chondrocyte implantation (MACI). Cell-based therapies differ from osteochondral procedures due to slow tissue maturation; cartilage healing resembles “growing grass,” requiring extended rehab and protection to avoid repair failure. PJEC is a single-stage morselized cartilage cell carrier suitable for smaller, contained defects and areas like the patella, needing intact bone but without bone preparation. Viable cartilage allograft, a newer putty-like product, shows promise for easier handling though lacks extensive data. MACI, a two-stage autologous chondrocyte culture procedure with extensive research, offers versatile defect coverage and improved techniques for minimally invasive implantation, favored for larger defects. Both PJEC and MACI require long recovery times, often up to a year. Insurance coverage influences treatment choice, with MACI generally reimbursed whereas PJEC often is not. Proper documentation and strategic reporting help minimize insurance denials and peer-to-peer reviews.

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Dr. Andreas Gomoll

Keywords

cell-based cartilage repair

particulate juvenile cartilage allograft

matrix-associated chondrocyte implantation

viable cartilage allograft

cartilage healing

insurance coverage