Comparison of Three Different Techniques for the Treatment of Cartilage Lesions—Matrix-Induced Autologous Chondrocyte Implantation (MACI) Versus Autologous Matrix-Induced Chondrogenesis (AMIC) and Arthroscopic Minced Cartilage—A 2-Year Follow-Up on P

<b>Background/Objectives</b>: The treatment of cartilage damage is an ongoing challenge. Several techniques have been developed to address this problem. Matrix-Induced Autologous Chondrocyte Implantation (MACI) is often referred to as the "gold standard" for cartilage treatment. Numerous long-term outcome studies also have reported favorable results with Autologous Matrix-Induced Chondrogenesis (AMIC). Minced Cartilage Implantation (MCI) is a recently developed arthroscopic method. This technique has demonstrated promising outcomes, with the prospect of longer-term results still under investigation. This study aims to directly compare the patient-reported outcomes of these three techniques over a 2-year follow-up period. <b>Methods</b>: A total of <i>N</i> = 48 patients were included in the retrospective matched pair analysis (<i>n</i> = 16 MACI, <i>n</i> = 16 AMIC, <i>n</i> = 16 MCI). VAS, KOOS-Pain, and KOOS-Symptoms scores served as primary outcomes; the KOOS-ADL and -QOL and the Tegner Activity Scale (TAS) served as secondary outcomes. <b>Results</b>: All three groups did not differ from each other in the primary or secondary outcomes. Pain and function significantly improved from pre-surgery to two years after (VAS: <i>p</i> < 0.000; ES: η² = 0.27; KOOS-Pain: <i>p</i> < 0.000; ES: η² = 0.30; KOOS-Symptoms: <i>p</i> = 0.000; ES: η² = 0.26; KOOS-ADL: <i>p</i> > 0.000; ES: η² = 0.20; KOOS-QOL: <i>p</i> > 0.000; ES: η² = 0.30). There was no significant effect of time on the activity level. <b>Conclusions</b>: All three procedures show good patient-reported outcomes, low complication rates, and long graft longevity in the 2-year follow-up. Therefore, all three methods seem to be equally recommendable for the treatment of cartilage lesions.