Treatments for chondral defects of the knee

Treatments to include in review for patients with chondral defects of the knee would be matrix-induced autologous chondrocyte implantation (MACI), autologous chondrocyte implantation (ACI), microfracture surgery, and osteochondral autologous transplantation (OATS) as potential alternatives to surgical knee cartilage repair strategy.

Osteochondral Autograft Transfer System surgery (OATS) was first reviewed by the HTCC in 2011.

  • In 2018, a review of OATS medical literature was performed to determine if evidence published since the 2011 review was likely to change the original decision.
  • In 2023, the HCA director selected treatments for chondral defects for review to include OATS and other technologies.

Status: Review in progress

Why are treatments for chondral defects being reviewed?

Significant questions remain about the safety, efficacy, and effectiveness, and cost effectiveness of OATS/mosaicplasty cartilage surgery, MACI, ACI, and microfracture surgery.

Primary criteria ranking

  • Safety = High
  • Efficacy = Medium
  • Cost = High

Documentation 

Assessment timeline

  • Draft key questions published: December 22, 2023
    • Public comment period: December 22, 2023 to January 5, 2024
  • Final key questions published: January 22, 2024
  • Draft report published: June 28, 2024
    • Public comment period: June 28 to July 27, 2024
  • Final report published: August 23, 2024
  • HTCC public meeting: September 20, 2024
  • Draft findings and decision published: September 30, 2024
    • Public comment period: September 30 to October 14, 2024
  • Final findings and decision published: November 27, 2024

 

All future dates are estimates and subject to change.