This very sophisticated discussion on the bulletin board will be of interest to readers who want to know what difference there is in outcome between ACI and Microfracture.

Positive first response from medical community...

Understanding the cartilage repair experience from the patients' perspective. by Karen Hambly BSc MCSP (Sports Scientist/Physiotherapist)

See Karen's Own Site

If you read through the reference given in the previous chapter, you will know by now that there are a number of possible surgical techniques that may benefit someone with joint cartilage damage in the knee. To help surgeons decide which procedure to do, a number of flowcharts (or 'algorithms') have been developed. The surgeon can estimate the depth of the damage and the width of the damaged area, and ask the patient questions about their lifestyle and age. Then by referring to the flowchart, the surgeon will have a fairly good idea of what surgery is likely to benefit the patient.

I am constantly amazed by some of the experiences that people tell me they go through when they go to see their physio after they have had articular cartilage repair. A couple of classics that I come across way too frequently are -

When I told my physio that I had ACI surgery they said "so you've had your ligament repaired! or 

When I went to the physio they had never heard of microfracture/OATS/Mosaicplasty/ACI (delete as appropriate!) and they had no details of my operation from the surgeon.

It wasn't until I found myself in the position of being a prospective patient for articular cartilage repair that I decided to do a bit of reading around the area. Now you may think that as I am a fully qualified chartered physiotherapist that I should have known all about articular cartilage problems and how they are managed. The reality of things is that the only time in the whole of my physio training that articular cartilage was ever mentioned was in relation to osteoarthritis.