186: From Defect to Comeback: Modern Cartilage Treatment Strategies: Dr. Aaron Krych LIVE at AOSSM 2026

Recorded live from the American Orthopaedic Society for Sports Medicine (AOSSM) Annual Meeting in Seattle, Dr. Aaron Krych joins Drs. Catherine Logan and Ashley Bassett for an in-depth discussion on the rapidly evolving field of cartilage restoration. The conversation explores how treatment has shifted from simply filling cartilage defects to restoring the entire knee joint through comprehensive patient evaluation, biologic innovations, and advanced surgical techniques.The Evolution of Cartilage RestorationWhy focal cartilage defects should be viewed as a "whole joint disease"Moving beyond isolated microfractureThe growing importance of correcting alignment, instability, and meniscal deficiencyEarlier intervention in young athletic patients to preserve long-term joint healthUnderstanding Natural HistoryWhy untreated cartilage defects can enlarge over timeRisk factors for lesion progression and development of secondary cartilage injuriesCounseling patients on long-term consequences and timing of interventionModern Treatment AlgorithmsWhy strict size-based algorithms are becoming less relevantPatient-specific factors influencing procedure selection:AgeActivity levelDefect size and locationSubchondral bone involvementPrevious surgeryOverall joint healthDiagnostic EvaluationThe expanding role of advanced MRIWhen diagnostic arthroscopy remains essentialEmerging applications of nano-arthroscopy for:Preoperative lesion evaluationAssessment of graft incorporationEvaluation of persistent postoperative symptomsSingle-Stage Cartilage Restoration TechniquesAutoCartSingle-stage autologous cartilage restorationSurgical technique pearlsCartilage harvest using GraftNet technologyPRP/BMAC augmentationTechnical considerations for successful implantationOsteochondral OptionsWhen bone involvement changes the treatment strategyIndications for:Osteochondral Autograft Transfer (OATS)Fresh Osteochondral Allograft TransplantationChoosing between autograft and allograft techniquesAlignment MattersWhy cartilage restoration cannot succeed in an overloaded compartmentIndications for combining osteotomy with cartilage restorationMedial high tibial osteotomy (HTO)Distal femoral osteotomy (DFO)Benefits of patient-specific instrumentation for osteotomy planning and executionLessons LearnedDr. Krych shares valuable experience on why successful cartilage restoration depends on more than the graft itself.Key factors influencing outcomes include:Proper patient selectionMechanical alignmentKnee stabilityMeniscal integrityPatient commitment to rehabilitationKey TakeawaysCartilage restoration has evolved from treating isolated defects to preserving the entire joint.Modern decision-making is individualized rather than based solely on defect size.Addressing alignment, instability, and meniscal deficiency is often just as important as restoring cartilage.Biologic augmentation and single-stage procedures continue to expand treatment options.Successful outcomes rely on appropriate patient selection and meticulous surgical technique.Featured GuestDr. Aaron Krych is an orthopedic sports medicine surgeon at Mayo Clinic specializing in cartilage restoration, complex knee preservation, ligament reconstruction, and sports-related injuries. His clinical expertise and research have helped shape many of today's modern cartilage restoration strategies.Subscribe to The Sports Docs Podcast for conversations with leaders in orthopedic sports medicine, surgery, injury prevention, rehabilitation, and athlete performance.www.cloganmd.comhttps://orthopedicnj.com/physicians/ashley-bassett