Live from the Arthrex Team Physician Controversies Conference

🎧 Episode Summary

In this episode of The Sports Docs Podcast, Dr. Ashley Bassett and Dr. Catherine Logan sit down LIVE from the Arthrex Team Physician Controversies with cartilage restoration expert Dr. Travis Maak to discuss the modern surgical management of knee cartilage defects.

The conversation focuses on diagnostic workup, surgical decision-making, and cutting-edge cartilage restoration techniques, including Autocart, BioCartilage, and Cartiform.

Diagnostic Imaging - MRI is critical for:

•  Defect size and depth 
•  Subchondral bone integrity and edema 
•  Concomitant meniscal and ligament pathology

Surgical Decision-Making

•  Patient age & activity level 
•  Lesion size, location, & containment 
•  Subchondral bone involvement 
•  Prior surgical history

Autocart (Autologous Minced Cartilage)

Single-stage autograft cartilage restoration technique
Uses patient’s own cartilage with PRP or BMAC
Key advantages:

•  Preserves native chondrocytes & extracellular matrix 
•  Avoids staged procedures 

Ideal for small-to-medium contained lesions

Outcomes:

•  Significant improvements in pain & function at ~5 years 
•  ~75% achieve clinically meaningful outcomes 
•  Low reoperation rates 

BioCartilage

Micronized cartilage extracellular matrix allograft scaffold
Used in combination with microfracture and biologics (PRP/BMAC)
Functions as a biologic bridge to enhance cartilage repair

Best for:

•  Small-to-medium, contained, full-thickness defects 
•  Well-aligned, stable knees 

Outcomes:

•  Improved pain and function at 2 years 
•  Better repair tissue quality compared to microfracture alone 

Cartiform

Cryopreserved osteochondral allograft with viable chondrocytes
 Maintains native cartilage architecture

Indicated for:

•  Larger lesions (>2 cm²) 
•  Defects with subchondral bone involvement 

Advantages:

•  Single-stage procedure 
•  Conforms to irregular defects 

Key Takeaways

• Cartilage restoration success depends on correcting biomechanics first
•  Procedure selection should be lesion-specific and patient-specific
•  Autocart offers a promising autograft solution with strong midterm data
•  BioCartilage fills the gap between microfracture and larger restoration procedures
•  Cartiform is a valuable option for larger defects and requires careful patient selection

Featured Guest

Dr. Travis Maak – University of Utah, Head Team Physician for the Utah Jazz, cartilage restoration and joint preservation specialist

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