Minced cartilage implantation for cartilage regeneration: a survey of current clinical practices

INTRODUCTION: The objective of this study is to evaluate how minced cartilage implantation (MCI) is currently applied in clinical settings, focusing on the selection criteria, procedural execution, handling of concomitant joint pathologies, and postoperative management. MATERIAL AND METHOD: An online survey was conducted among all 4,915 members of the German Society for Arthroscopy and Joint Surgery (AGA). Invitations with a survey link were emailed, and the questionnaire was accessible anonymously from January 10 to February 20, 2024. A total of 927 responses were received and analyzed, resulting in a 19% response rate. Demographic data were described descriptively; survey answers were reported as percentages. The 25-item questionnaire, developed by AGA and the Quality Circle for Cartilage Repair & Joint Preservation (QKG e.V.), included single- and multiple-choice questions on experience with cartilage therapy, minced cartilage procedure application and postoperative care, and the overall assessment of this technique within cartilage repair. RESULTS: MCI has emerged as one of the three most commonly used cartilage repair techniques in the knee joint. Defect sizes up to 4 cm² represent the largest treated group. The application of the procedure is quite heterogeneous, with some practitioners using a shaver and others manually mincing with a scalpel. Fixation methods also vary, including the use of autologous and allogeneic fibrin as well as collagen membranes. The targeted fragment size is largely consistent across users. Postoperative management is similar, with most recommending partial weight-bearing for six weeks. CONCLUSION: Minced cartilage implantation has become an increasingly utilized technique for cartilage repair. Although the current evidence has improved - particularly due to the growing number of case series - there are still notable variations in how the procedure is performed.