Cartilage Repair and Regeneration

Successful cartilage repair surgery reduces pain and restores function. There are numerous cartilage repair treatment options available, and the suitability of each of these approaches depends on each patient’s unique clinical problem. Physicians in the HSS Institute for Cartilage Repair are experts in the treatment of damaged articular cartilage. Our clinical approaches are data-driven and, consequently, our physicians note high clinical success rates in their respective patient populations. HSS experts offer the full range of contemporary cartilage repair and restoration options, including newer single-stage and minimally invasive techniques such as arthroscopic MACI.

What is cartilage repair (cartilage regeneration)?

In its simplest terms, cartilage repair (regeneration) surgery results in the formation of robust cartilage-like tissue around the joint where the cartilage has worn away or been damaged. Cartilage regeneration typically requires some sort of surgical intervention. Biologic or synthetic scaffolds are often used to help successfully regenerate articular cartilage. Adults don’t have the natural capability to grow new articular cartilage from scratch. This ability is only possible in a fetus growing inside the womb. This fact makes cartilage repair surgery challenging.

How is damage to cartilage diagnosed?

Our physicians will take a full medical history, perform a physical exam, and utilize imaging studies (X-rays, MRIs, CT scans) to determine the location and extent of the articular cartilage damage. Advanced MRI technology allows surgeons to design a personalized treatment plan prior to surgery. Follow-up MRI readings may be taken after surgery to allow for an objective assessment of cartilage growth and healing and can help formulate an individualized rehabilitation plan that will help facilitate a complete recovery.

Can cartilage heal on its own?

No. Articular cartilage is the smooth cushion that lines the ends of bones where they meet at joints such as the knee, shoulder and ankle. In healthy joints, intact articular cartilage allows bones to move against one another without friction. Cartilage contains no nerves and does not have a blood supply. As such, cartilage does not have the capacity to heal on its own.

Can damaged cartilage be repaired?

Repair of damaged existing cartilage cannot usually be performed. But there are treatment options in which damaged articular cartilage may be replaced or reconstructed using cell-based or tissue-based strategies.

For example, one commonly performed procedure – mosaicplasty (also known as "osteochondral autograft transplant surgery" or OATS) – works by taking small cylinders of cartilage from one area of a patient’s joint (typically a non-weight-bearing area) to reconstruct and fill a cartilage defect in a separate weight-bearing area. Another commonly performed procedure uses donated cartilage tissue (osteochondral allograft) to reconstruct large joint cartilage lesions. In yet another method, small arthroscopically harvested cartilage samples can be used to grow a customized cartilage “patch” that can be used to fill a cartilage defect. In many cases, this patch can now be implanted arthroscopically. Surgeons at HSS have been performing cartilage procedures since the 1990s and have been at the forefront of developing all of these described methodologies.

Who is a good candidate for cartilage repair?

The ideal cartilage repair candidate is someone who suffers from an isolated articular cartilage defect. The patient should have a relatively healthy knee with no generalized cartilage loss (arthritis). The treated knee should be well-aligned and stable, meaning that there are no ligament deficiencies. If malalignment or ligament deficiencies are present, then these are corrected at the same time. Cartilage repair can be performed on people of all ages but, typically, patients are under 50 years of age.

What conditions may be treated with cartilage repair?

Cartilage injuries that can be treated by cartilage repair surgery include:

• articular cartilage defects
• chondral defects
• chondral lesions
• osteochondral defects
• osteochondritis dissecans (OCD) lesions
• avascular necrosis (AVN), also known as osteonecrosis

What are the types of procedures for cartilage repair?

Due to recent medical advances, there are now multiple treatment options available, depending on factors such as size of the cartilage damage and a patient’s end goals. These include:

• debridement or chondroplasty
• microfracture surgery with or without biologic augmentation
• whole tissue options (osteochondral grafts)
• matrix-induced autologous chondrocyte implantation (open or arthroscopic)
• allogeneic articular cartilage grafts (particulate juvenile articular cartilage allograft transplantation [PJAC] and autologous minced cartilage)
• aragonite-based scaffold implants (CartiHeal Agili-C)
• focal metallic resurfacing (Overture)

Debridement or chondroplasty

The objective of this procedure is to alleviate pain and mechanical symptoms (clicking, catching, or locking) associated with cartilage lesions. The surgeon will remove the loose fragments of cartilage that are causing joint pain and smooth the remaining surface. This procedure allows for an expedited recovery and allows for the surgeon to better understand the true extent of cartilage damage first seen on MRI.

At the same time, it may be beneficial inject an adjunctive biologic treatment, such as bone marrow aspirate concentrate (BMAC). This is a concentration of the patient’s own bone marrow cells, which aid in healing. Sometimes, a bridging procedure like this is appropriate if the patient is an in-season athlete. If a MACI procedure is indicated, the cartilage biopsy can also be taken at this stage.

Microfracture surgery

This arthroscopic bone marrow stimulation procedure involves creating small holes in the base of the cartilage lesion to promote a biologic healing response and create cartilage repair tissue. This is used to treat small areas of cartilage damage – especially in irregularly shaped defects or for those in challenging-to-access locations like the tibia – and can be effective for short-term treatment of knee cartilage defects. However, modern techniques are best for people who seek a durable long-term solution, and research from HSS found that athletes treated with microfracture are less likely to return to their prior level of sport than those treated with other cartilage repair techniques.²¹

Microfracture can also be paired with BMAC alone, or with allogeneic cartilage matrices, in which the defect bed is then filled with a paste made from finely ground donor cartilage, mixed with the patient’s own blood products (such as BMAC or platelet-rich plasma [PRP]) and, finally, sealed with a biologic glue. The donor therefore works as a scaffold that supports the body’s own healing response. HSS research has shown improvement in pain and function at early follow-up (two years after surgery), while long term studies are still be performed.^{4, 6}

Whole tissue options

Osteochondral autograft transplantation surgery (OATS)

In OATS, surgeons take articular cartilage from a healthy, non-weight-bearing area of the patient’s knee and transplant it to the small, damaged area of articular cartilage. This procedure is also known as an autologous osteochondral transfer (AOT) or mosaicplasty. Use of the patient’s own tissue facilitates a very durable repair and excellent clinical outcomes. This method has shown strong results in individuals participating in high-demand activities. Research from HSS has shown that most patients maintain meaningful improvements in pain and function 10 years after OATS, although a subset may need a second cartilage procedure.^{2, 19}

Osteochondral allograft transplantation (OCA)

In OCA, surgeons use whole donor tissue specimens to treat cartilage lesions. This method is best for medium or large lesions, and those lesions that also involve the underlying subchondral bone (osteochondritis dissecans, avascular necrosis). Osteochondral allograft surgery can also be performed as a salvage procedure for other failed cartilage repair surgeries.²² Cartilage allograft surgery may not be as durable in the long run in highly active people, with factors such as older age, higher body weight, and bipolar cartilage damage (defects on both sides of the joint) resulting in a higher risk of graft failure.¹⁸

Matrix-induced autologous chondrocyte implantation (MACI)

Autologous chondrocyte implantation has a long history of clinical success and is one of the most common techniques used today for repairing knee cartilage. In the matrix-induced autologous chondrocyte implantation procedure, surgeons take a small sample of healthy cartilage from the knee in a small surgery. The cells are isolated, grown in a lab, and seeded onto a collagen patch. During surgery, the patch is shaped and glued into the cartilage defect. This patch ultimately grows into new, healthy cartilage repair tissue. 

Research has proven this to be very effective for injuries of the femur (thighbone), patella (kneecap), trochlea (the groove on the femur in which the kneecap glides), and tibia (shin bone). Studies that have followed patient outcomes for 10 years or longer show lasting improvements in pain and function with low rates of reoperation.²⁸ At HSS, the second stage (implantation) of MACI can be performed using a minimally invasive, arthroscopic technique using small incisions rather than the traditional open approach.⁸

Allogeneic articular cartilage grafts

Particulate juvenile articular cartilage allograft transplantation

This procedure uses small fragments of donor cartilage tissue to facilitate the formation of cartilage repair tissue. Unlike osteochondral allografts, this method has no associated bone with the cartilage. The surgeon transplants small pieces of donated cartilage into the damaged area and secures the transplant with a fibrinous glue. The transplanted cartilage grows quickly into durable cartilage repair tissue. Studies out of HSS have demonstrated the clinical efficacy of this method in individuals who perform high-demand activities.

Autologous minced cartilage

In appropriately selected patients, autologous cartilage obtained from the knee during the debridement or clean-up stage may also be captured and prepared using a specialized device, which is then mixed with PRP. The paste is then placed back into the cartilage defect and secured with a biologic glue to lock the living cells in place.

Aragonite based scaffold implantation (CartiHeal Agili-C)

This single-stage procedure uses an off-the-shelf, cell-free implant made from aragonite, a natural mineral derived from coral. Through a small incision, the surgeon creates a small socket at the site of the cartilage damage and press-fits the implant into place. The scaffold is designed to support the growth of new bone and cartilage-like tissue. The implant was approved by the FDA in 2022 for cartilage defects of the knee with a total area of 1 to 7 square centimeters, including in patients with mild to moderate arthritis.¹⁵ In a large randomized clinical trial, patients treated with the scaffold had greater improvements in pain and function at two years, and a lower rate of treatment failure, than patients treated with debridement or microfracture.¹

Focal metallic resurfacing

For some patients whose cartilage damage is limited to one area, but who are not good candidates for biologic repair, a small metal implant can be used to resurface only the damaged area. This procedure, sometimes called focalplasty, uses a titanium implant (such as the OvertureTi Knee Resurfacing System) that is sized to match the defect and then fixed to the bone. The surrounding healthy cartilage, meniscus and ligaments are preserved. Compared with a partial or total knee replacement, focal resurfacing removes less bone, which may help keep future treatment options open. Because these implants are newer, long-term results are still being studied.

How long does cartilage repair surgery take?

Most of the described surgical procedures take less than an hour. Surgeries can be performed arthroscopically but may require a small incision to fully execute the procedure. Combining the cartilage repair procedure with other surgeries (ligament reconstruction, osteotomy) may lengthen the procedure accordingly.

How long does it take to recover from cartilage repair surgery?

Most patients use crutches for the first 2 to 3 weeks after surgery. Physical therapy usually starts about a week after surgery on an outpatient basis. Most patients can return to normal activities of daily living 4 to 6 weeks after surgery. Many patients are cleared for some sports after six months. However, getting back to a high level of fitness or ballistic sports may take longer. Different surgical treatment options have different timetables for a return to high level activities. Osteochondral autograft and allograft patients usually can expect to be cleared at six months. In contrast, for the MACI procedure – because it requires two surgeries spaced 6 to 8 weeks apart, the full recovery time is closer to 12 to 18 months.

Physical therapy is an important part of recovery and should be utilized as appropriate. Postoperative MRIs are used to assess the success of the procedure and show progress through the physical therapy process.

How long before you can return to exercise after cartilage repair?

If you are looking to go back to heavy exercise or athletics, it is important to work with a strength and conditioning coach to help with training. Most professional athletes are able to return to sport after cartilage restoration surgery of the knee, although timelines vary.²⁰

What are the potential risks of cartilage repair?

There is no more risk involved than typical surgical risk. However, risks specific to cartilage repair surgery include the need for a revision cartilage surgery if the repair tissue or graft does not heal or wears down over time. Revision cartilage surgery to promote continued joint preservation is an option for some patients but may carry a higher risk of complications.²² Your surgeon will discuss your individual risks with you before surgery.

What is the success rate for cartilage repair?

As a subspecialty, cartilage repair surgery has rapidly evolved since its inception in the late 1990s. Before that time, there were few treatment options available to address this clinical problem. Now, there are numerous ways to treat cartilage damage that can be individualized to each patient. Success rates truly depend on several factors (surgery performed, patient age, body mass index, duration of symptoms etc.). Our surgeons have tracked their clinical outcomes in this area since 1998. The HSS Cartilage Registry tracks the clinical outcomes of over 4,000 patients who have been treated for symptomatic cartilage defects. Our surgeons recommend custom treatment options based on objective data and clinical outcomes. Contemporary research has supported these results.

An HSS study analyzed 2,300 athletes and found that approximately 80% returned to sport after cartilage restoration surgery of the knee, with MACI and OCA being the most predictable treatments that allowed return to competition at the same or higher levels.²¹

Can cartilage be repaired without surgery?

Simply, no. In most cases, surgery is required to repair articular cartilage.

In rare cases, small traumatic cartilage lesions form a repair tissue called fibrocartilage on their own. This typically occurs at the time of injury if there is a significant amount of bleeding and trauma. Fibrocartilage is located between the vertebra of the spine, in the meniscus of the knee, and in joint capsules that surround some joints. Fibrocartilage is inferior to articular cartilage for the purposes of bearing loads in a joint. Injections such as PRP or BMAC may help relieve symptoms in the short term but do not regrow articular cartilage.

What vitamins or supplements help repair cartilage?

Taking vitamins does not help cartilage to repair itself. However, there are supplements that can play a role in controlling and limiting joint inflammation that is associated with cartilage damage. Oral supplements such as glucosamine sulfate or hyaluronic acid can be helpful in relieving symptoms. Neither of these substances have been clinically proven to promote or result in the repair of damaged cartilage. It is our recommendation that it is best to consult with your physician before adding any supplements to your diet.

Key takeaways

• Articular cartilage has little ability to heal on its own, so symptomatic cartilage damage often requires surgery to repair or replace it.
• The best treatment depends on the size and location of the cartilage damage, the health of the rest of the joint, and the patient’s age and activity goals.
• Contemporary cartilage repair options range from arthroscopic debridement and microfracture to cartilage transplantation (OCA), MACI, and aragonite-based and focal metallic scaffolds.
• Surgeons from the HSS Institute for Cartilage Repair offer all contemporary cartilage options and can help decide which is right for you.
• Long-term studies show that most patients experience meaningful and lasting improvements in pain and function with cartilage repair and that the vast majority of athletes can return to sport.

Learn more about individual cartilage repair surgical procedures and related conditions and treatments in the content below.

1. Altschuler N, Zaslav KR, Di Matteo B, Sherman SL, Gomoll AH, Hacker SA, Verdonk P, Dulic O, Patrascu JM, Levy AS, Robinson D, Kon E. Aragonite-Based Scaffold Versus Microfracture and Debridement for the Treatment of Knee Chondral and Osteochondral Lesions: Results of a Multicenter Randomized Controlled Trial. Am J Sports Med. 2023 Feb;51(4):957-967. doi: 10.1177/03635465231151252. PMID: 36779614. https://pubmed.ncbi.nlm.nih.gov/36779614/
2. Amoo-Achampong K, Kunze KN, Ramkumar PN, Khorana A, Williams RJ 3rd. Midterm Outcomes of Primary Osteochondral Autograft Transfer for Symptomatic Chondral Defects of the Knee. Orthop J Sports Med. 2026 Jan;14(1):23259671251399796. doi: 10.1177/23259671251399796. PMID: 41552618; PMCID: PMC12811580. https://pubmed.ncbi.nlm.nih.gov/41552618/
3. Brittberg M, Gomoll AH, Canseco JA, Far J, Lind M, Hui J. Cartilage repair in the degenerative ageing knee. Acta Orthop. 2016 Dec;87(sup363):26-38. doi: 10.1080/17453674.2016.1265877. Epub 2016 Dec 2. PMID: 27910738; PMCID: PMC5389429. https://pubmed.ncbi.nlm.nih.gov/27910738/
4. Brusalis CM, Greditzer HG, Fabricant PD, Stannard JP, Cook JL. BioCartilage augmentation of marrow stimulation procedures for cartilage defects of the knee: Two-year clinical outcomes. Knee. 2020 Aug;27(5):1418-1425. doi: 10.1016/j.knee.2020.07.087. PMID: 33010756. https://pubmed.ncbi.nlm.nih.gov/33010756/
5. Choi YS, Potter HG, Chun TJ. MR imaging of cartilage repair in the knee and ankle. Radiographics. 2008 Jul-Aug;28(4):1043-59. doi: 10.1148/rg.284075111. PMID: 18635628. https://pubmed.ncbi.nlm.nih.gov/18635628/
6. Cole BJ, Haunschild ED, Carter T, Meyer J, Fortier LA, Gilat R, et al. Clinically Significant Outcomes Following the Treatment of Focal Cartilage Defects of the Knee With Microfracture Augmentation Using Cartilage Allograft Extracellular Matrix: A Multicenter Prospective Study. Arthroscopy. 2021 Feb;37(5):1512-1521. doi: 10.1016/j.arthro.2021.01.043. PMID: 33539978. https://pubmed.ncbi.nlm.nih.gov/33539978/
7. Crawford DC, DeBerardino TM, Williams RJ 3rd. NeoCart, an autologous cartilage tissue implant, compared with microfracture for treatment of distal femoral cartilage lesions: an FDA phase-II prospective, randomized clinical trial after two years. J Bone Joint Surg Am. 2012 Jun 6;94(11):979-89. doi: 10.2106/JBJS.K.00533. PMID: 22637204. https://pubmed.ncbi.nlm.nih.gov/22637204/
8. Ebert JR, Edwards PK, Klinken S, Wood DJ, Janes GC. A Prospective Clinical and Magnetic Resonance Imaging-Based Follow-up Beyond 10 Years After Arthroscopic Matrix-Induced Autologous Chondrocyte Implantation. Am J Sports Med. 2026 Jul;54(10):2462-2472. doi: 10.1177/03635465261459242. PMID: 42466622; PMCID: PMC13424900. https://pubmed.ncbi.nlm.nih.gov/42466622/
9. Fernandes TL, Cortez de SantAnna JP, Frisene I, Gazarini JP, Gomes Pinheiro CC, Gomoll AH, Lattermann C, Hernandez AJ, Franco Bueno D. Systematic Review of Human Dental Pulp Stem Cells for Cartilage Regeneration. Tissue Eng Part B Rev. 2020 Feb;26(1):1-12. doi: 10.1089/ten.TEB.2019.0140. Epub 2020 Jan 22. PMID: 31744404. https://pubmed.ncbi.nlm.nih.gov/31744404/
10. Fernandes TL, Gomoll AH, Lattermann C, Hernandez AJ, Bueno DF, Amano MT. Macrophage: A Potential Target on Cartilage Regeneration. Front Immunol. 2020 Feb 11;11:111. doi: 10.3389/fimmu.2020.00111. PMID: 32117263; PMCID: PMC7026000. https://pubmed.ncbi.nlm.nih.gov/32117263/
11. Hede KTC, Gomoll AH, Foldager CB. Demographics in Patients Receiving Matrix-Assisted Chondrocyte Implantation (MACI) in the Ankle. Cartilage. 2021 Dec;13(1_suppl):1331S-1336S. doi: 10.1177/1947603519870854. Epub 2019 Aug 20. PMID: 31431042. https://pubmed.ncbi.nlm.nih.gov/31431042/
12. Hinckel BB, Gomoll AH. Autologous Chondrocytes and Next-Generation Matrix-Based Autologous Chondrocyte Implantation. Clin Sports Med. 2017 Jul;36(3):525-548. doi: 10.1016/j.csm.2017.02.008. PMID: 28577711. https://pubmed.ncbi.nlm.nih.gov/28577711/
13. Hinckel BB, Gomoll AH. Patellofemoral Cartilage Restoration: Indications, Techniques, and Outcomes of Autologous Chondrocytes Implantation, Matrix-Induced Chondrocyte Implantation, and Particulated Juvenile Allograft Cartilage. J Knee Surg. 2018 Mar;31(3):212-226. doi: 10.1055/s-0037-1607294. Epub 2017 Oct 16. PMID: 29036754. https://pubmed.ncbi.nlm.nih.gov/29036754/
14. Hutchinson ID, Moran CJ, Potter HG, Warren RF, Rodeo SA. Restoration of the meniscus: form and function. Am J Sports Med. 2014 Apr;42(4):987-98. doi: 10.1177/0363546513498503. Epub 2013 Aug 12. PMID: 23940202. https://pubmed.ncbi.nlm.nih.gov/23940202/
15. Kon E, Di Matteo B, Verdonk P, Drobnic M, Dulic O, Gavrilovic G, Patrascu JM, Zaslav K, Kwiatkowski G, Altschuler N, Robinson D. Aragonite-Based Scaffold for the Treatment of Joint Surface Lesions in Mild to Moderate Osteoarthritic Knees: Results of a 2-Year Multicenter Prospective Study. Am J Sports Med. 2021 Jan;49(3):588-598. doi: 10.1177/0363546520981750. PMID: 33481631. https://pubmed.ncbi.nlm.nih.gov/33481631/
16. Krych AJ, Harnly HW, Rodeo SA, Williams RJ 3rd. Activity levels are higher after osteochondral autograft transfer mosaicplasty than after microfracture for articular cartilage defects of the knee: a retrospective comparative study. J Bone Joint Surg Am. 2012 Jun 6;94(11):971-8. doi: 10.2106/JBJS.K.00815. PMID: 22637203. https://pubmed.ncbi.nlm.nih.gov/22637203/
17. Krych AJ, Robertson CM, Williams RJ 3rd; Cartilage Study Group. Return to athletic activity after osteochondral allograft transplantation in the knee. Am J Sports Med. 2012 May;40(5):1053-9. doi: 10.1177/0363546511435780. Epub 2012 Feb 7. PMID: 22316548. https://pubmed.ncbi.nlm.nih.gov/22316548/
18. Kunze KN, Ramkumar PN, Manzi JE, Wright-Chisem J, Nwachukwu BU, Williams RJ 3rd. Risk Factors for Failure After Osteochondral Allograft Transplantation of the Knee: A Systematic Review and Exploratory Meta-analysis. Am J Sports Med. 2022 Jan;51(5):1356-1367. doi: 10.1177/03635465211063901. PMID: 35049404. https://pubmed.ncbi.nlm.nih.gov/35049404/
19. Kunze KN, Varady NH, Khorana A, Rodeo SA, Warren RF, Wickiewicz TL, Williams RJ 3rd. Defining clinically relevant outcome thresholds for pain and function after osteochondral autograft transplantation of the knee. Knee Surg Sports Traumatol Arthrosc. 2024 Aug;33(4):1183-1191. doi: 10.1002/ksa.12422. PMID: 39126271. https://pubmed.ncbi.nlm.nih.gov/39126271/
20. Kunze KN, Uzzo RN, Thomas ZD, Hicks J, Rodeo SA, Williams RJ 3rd. Return to Sport in Professional Athletes After Cartilage Restoration Surgery of the Knee: A Systematic Review and Meta-Analysis Demonstrates Gender Inequality and the Need for Improved Reporting. Cartilage. 2024 Dec;16(4):409-418. doi: 10.1177/19476035241292793. PMID: 39688238; PMCID: PMC11653380. https://pubmed.ncbi.nlm.nih.gov/39688238/
21. Kunze KN, Mazzucco M, Thomas Z, Uzzo R, Rodeo SA, Warren RF, Wickiewicz TL, Williams RJ 3rd. High Rate of Return to Sport for Athletes Undergoing Articular Cartilage Restoration Procedures for the Knee: A Systematic Review of Contemporary Studies. Am J Sports Med. 2025 Jan;53(10):2471-2482. doi: 10.1177/03635465241280975. PMID: 39790040. https://pubmed.ncbi.nlm.nih.gov/39790040/
22. Kunze KN, Persaud S, Briano J, Rodeo SA, Warren RF, Wickiewicz TL, Williams RJ 3rd. Outcomes of Revision Cartilage Restoration Surgery for Failed Primary Treatment of Chondral or Osteochondral Defects of the Knee: A Systematic Review. Am J Sports Med. 2025 Jan;53(6):1515-1523. doi: 10.1177/03635465241260271. PMID: 39757922. https://pubmed.ncbi.nlm.nih.gov/39757922/
23. Makris EA, Gomoll AH, Malizos KN, Hu JC, Athanasiou KA. Repair and tissue engineering techniques for articular cartilage. Nat Rev Rheumatol. 2015 Jan;11(1):21-34. doi: 10.1038/nrrheum.2014.157. Epub 2014 Sep 23. PMID: 25247412; PMCID: PMC4629810. https://pubmed.ncbi.nlm.nih.gov/25247412/
24. Mestriner AB, Ackermann J, Gomoll AH. Patellofemoral Cartilage Repair. Curr Rev Musculoskelet Med. 2018 Jun;11(2):188-200. doi: 10.1007/s12178-018-9474-3. PMID: 29777422; PMCID: PMC5970109. https://pubmed.ncbi.nlm.nih.gov/29777422/
25. Moran CJ, Pascual-Garrido C, Chubinskaya S, Potter HG, Warren RF, Cole BJ, Rodeo SA. Restoration of articular cartilage. J Bone Joint Surg Am. 2014 Feb 19;96(4):336-44. doi: 10.2106/JBJS.L.01329. PMID: 24553893. https://pubmed.ncbi.nlm.nih.gov/24553893/
26. Ramkumar PN, Karnuta JM, Haeberle HS, Rodeo SA, Nwachukwu BU, Williams RJ 3rd. Effect of Preoperative Imaging and Patient Factors on Clinically Meaningful Outcomes and Quality of Life After Osteochondral Allograft Transplantation: A Machine Learning Analysis of Cartilage Defects of the Knee. Am J Sports Med. 2021 May;49(8):2177-2186. doi: 10.1177/03635465211015179. PMID: 34048288. https://pubmed.ncbi.nlm.nih.gov/34048288/
27. Thamrongskulsiri N, Valdivia San Roman A, Moews LD, Vega TF, Casanova F, Morgan JT, Nishioka T, Chahla J. Focalplasty for Resurfacing of Focal Articular Lesions of the Medial Femoral Condyle. Video J Sports Med. 2026 Aug;6(4):26350254261429887. doi: 10.1177/26350254261429887. PMID: 42571111; PMCID: PMC13451671. https://pubmed.ncbi.nlm.nih.gov/42571111/
28. Wang AS, Nagelli CV, Lamba A, Saris DBF, Krych AJ, Hevesi M. Minimum 10-Year Outcomes of Matrix-Induced Autologous Chondrocyte Implantation in the Knee: A Systematic Review. Am J Sports Med. 2024 Feb;52(9):2407-2414. doi: 10.1177/03635465231205309. PMID: 38312085; PMCID: PMC12456864. https://pubmed.ncbi.nlm.nih.gov/38312085/
29. Williams, Riley J. ,, Peterson, L., Cole, B. J., & Humana Press Inc. (2016). Cartilage Repair Strategies.
30. Williams RJ 3rd, Director of the Institute for Cartilage Repair and Attending Orthopedic Surgeon, Hospital for Special Surgery. Video interview, October 14, 2021.