Cartilage Surgery · Sports Medicine
Advanced cartilage repair and restoration procedures — including MACI, microfracture, and osteochondral grafting — for patients with cartilage defects of the knee. Dr. Strassman was the first surgeon in Wisconsin to perform arthroscopic MACI. Serving Platteville, WI, Dubuque, IA, and the tri-state region.
Understanding Cartilage
Articular cartilage is the smooth white tissue that covers the ends of bones in a joint, allowing near-frictionless movement. Unlike most tissues, cartilage has very limited ability to heal on its own — it has no blood supply and virtually no regenerative capacity.
Cartilage defects in the knee are common — caused by trauma, osteochondritis dissecans (OCD), or gradual degeneration — and can cause significant pain, swelling, and mechanical symptoms. Left untreated, focal defects often progress toward more widespread arthritis.
The goal of cartilage restoration surgery is to fill the defect with tissue that closely resembles native hyaline cartilage, restoring a smooth, functional joint surface. The right procedure depends on the size of the defect, patient age, activity level, and prior treatments.
Who may have a cartilage defect?
Young, active patients with knee pain out of proportion to their age
History of knee trauma or ACL injury with persistent symptoms
MRI findings of focal cartilage loss or osteochondral lesion
Swelling, catching, or locking with activity
Prior failed cartilage procedure (e.g. microfracture) or prior arthroscopic finding
Featured Procedure
MACI (Matrix-Induced Autologous Chondrocyte Implantation) is the most advanced FDA-approved cartilage restoration procedure available. It uses the patient's own cartilage cells — harvested, grown in a laboratory, and embedded in a collagen matrix — to grow new, durable hyaline-like cartilage that fills the defect.
Dr. Strassman performs MACI arthroscopically — a technically demanding approach that reduces recovery time compared to open implantation while achieving the same biological outcome. He was the first surgeon in Wisconsin to perform arthroscopic MACI (2025), making this technology available to patients in the tri-state region who previously would have needed to travel to academic medical centers.
Arthroscopic procedure harvests a small sample of healthy cartilage from a non-weight-bearing area of your knee. Outpatient procedure, 30–45 minutes.
Your chondrocytes are isolated, multiplied, and seeded onto a porcine collagen membrane in a specialized laboratory — growing into a living graft tailored to your defect size.
The MACI graft is trimmed to fit the defect and secured with fibrin glue arthroscopically. The cells then mature into hyaline-like cartilage over 12–18 months.
Other Cartilage Procedures
The best cartilage procedure depends on defect size, bone involvement, and prior treatment history. Dr. Strassman performs the full spectrum of cartilage procedures.
Small perforations are made in the subchondral bone to stimulate a blood clot that differentiates into fibrocartilage. Best for smaller defects (<2cm²) in younger patients. Minimally invasive, single-stage.
Cylindrical plugs of bone and cartilage are harvested from a low-load area of the knee and transplanted to fill the defect. Provides immediate structural support with native hyaline cartilage. Best for medium-sized defects with bone involvement.
Best for larger defects (>3cm²), failed prior procedures, or cases where hyaline-quality cartilage regeneration is the goal. Two-stage procedure using the patient's own cells. FDA-approved with strong long-term outcome data.
Rehabilitation
MACI recovery is one of the most involved rehabilitation protocols in sports medicine — the newly implanted cells require careful protection during maturation. Patience and protocol adherence are critical to achieving the best outcome.
Crutches required. Continuous passive motion (CPM) machine often prescribed to nourish the graft with joint fluid. No loading of the repair site.
Gradual transition to full weight bearing. Stationary bike, pool walking, and range of motion exercises. Low-impact movement promotes graft maturation.
Progressive closed-chain strengthening. Neuromuscular training. Light jogging typically introduced around month 5–6 based on clinical criteria.
Sport-specific training, cutting, and agility. Full return to unrestricted sport typically occurs at 12–18 months as the graft continues to mature and harden.
MACI cartilage continues to mature and consolidate throughout the first 18 months. Patients often note continued improvement well into the second year.
Common Questions