I originally wrote this post, which garnered a good deal of attention, about these two procedures.
I said that if forced to choose between the two, I’d rather have the less-invasive (and less-expensive) microfracture, which may even be more effective. In the comments section, several people disagreed. One commenter said that, over the long-term, ACI (or autologous chondrocyte implantation) leads to a better result.
Uh, maybe not.
This study (published in August in the reputable Journal of Bone and Joint Surgery) looked at large lesions treated with either ACI or microfracture. The 80 subjects were evaluated after 15 years (a suitably long timeframe, I think all would agree).
Check out the highlights:
* There were 17 failures in the ACI group compared with 13 for those who had microfractures.
* Total knee replacements: six in the ACI group, three in the microfracture.
* X-ray evidence of early osteoarthritis: 57 percent in the ACI group vs. 48 percent in the microfracture.
Luckily I don’t have to choose between either. But if I did, I think I’d stick with my original answer.