I wouldn't worry about the microfracture. If you are getting the ACI procedure then your OS can either re-microfracture and do ACI on the tibial lesion when he is in there for the ACI procedure. Why didn't he wait to do this? Sometimes it is difficult to get ACI approved for the Patella as it is off-label. I've had both micro and ACI done for my 2CM patella lesion. Micro was 9 months ago (never got better and the defect grew in size from 1 to 2 cm) and the ACI 4 weeks ago. Microfracture isn't the way to go with the patella. Fibrocartilage doesn't hold up to the sheer forces of the patella. I had a personal coversation with Dr. Steadman himself about this. If you need a realignment, you might as well get some cells put in your defect while they inside your joint. It is a longer recovery but the results are better. I was full weight bearing as tolerated after both surgeries. I do have to keep my leg straight all day and there are limitations with the CPM in terms of ROM. Good luck and take it easy on that knee before surgery. You don't want that defect to get any larger.