r/MACIknee

Hey everyone, looking for how your surgeries and recoveries went. I'm a young athlete, and I'm no stranger to knee pain. My right knee cap is pretty wrecked and pops out often with me manually having to put it back into place. MPFL is wrecked and it's been 22 years of trying to fix this since I was a kid and first hurt it. Had one surgery before when I had a major trauma and broke the kneecap in half. Knee joint itself is super healthy, it's just the patella that's really bad and the maltracking that needs to be fixed with the TTO. I am extremely active and have put in a ton of hours at the gym to get my muscles as strong as possible before surgery. I'm interested in hearing from others who are in similar physical condition on the pain level you experienced and how quickly you were able to get back up and running. I also can't take pain meds other than Tylenol or ibuprofen, so I know it's going to suck more because of that.

Heya all, did some light searching but didn’t really find much. Going under the knife for stage one f my Patellar MACI procedure next week. I’ve already had one scope and a meniscus repair on this knee, so I’m not terribly worried about that part.

I am however a bit freaked about the second stage. I’m an avid cyclist: a bike messenger, and an ultra distance rider. Wondering if there’s anyone here with similar hobbies that have gotten this procedure, and what their return to riding looked like. I know everyone is different, just trying to prepare mentally for as many eventualities as possible.

I’m 24 and have a Grade IV osteochondral/OCD lesion of the medial femoral condyle in my right knee.

My MRI shows:

• Osteochondral defect: 22 mm AP × 15 mm transverse
• Defect depth: 7.7 mm
• There is fluid tracking underneath the margins of the defect
• A 15 × 7 mm osteochondral fragment is displaced into the suprapatellar recess
• Small joint effusion
• Menisci and ligaments are otherwise intact
• Alignment is maintained
• The remaining articular cartilage is reported as normal

The displaced fragment cannot be salvaged/fixed, so I’m looking at cartilage/osteochondral restoration options.

Unfortunately, fresh osteochondral allograft is not available to me, so the options currently available to me include MACI and OATS/mosaicplasty.

I would really appreciate input from anyone who has experience with a lesion of this size, particularly orthopedic surgeons, cartilage restoration specialists, or people who have gone through treatment for a similar OCD lesion.

For a 22 × 15 mm (~3.3 cm²) Grade IV lesion with 7.7 mm of depth in the medial femoral condyle:

• Would OATS/mosaicplasty be a reasonable choice for a defect this size and depth?
• Would MACI be preferable?
• Are there other procedures or treatment approaches I should be considering besides MACI and OATS/mosaicplasty?
• How does the 7.7 mm bone involvement/depth affect the choice between these procedures?
• For someone in their early 20s, which option would generally be considered better for long-term durability and preserving the knee?
• If you’ve had a similar-sized lesion, what procedure did you have and how is your knee doing now?

I’m trying to understand all the realistic options available to me before making a decision, since an osteochondral allograft isn’t an option where I am.

I’ve attached the MRI report/images for reference. I’d especially appreciate responses from people with similar-sized medial femoral condyle OCD lesions, rather than smaller cartilage defects.

Quick background: MACI on July 9th, 2026 (combined patellofemoral + tibiofemoral, left knee, 4 weeks post op at time of writing). No CPM machine: my surgeon's team has moved away from them and had me doing heel slides instead as the main ROM driver.

I was aggressive with heel slides early (weeks 0-2.5) but obviously limited by how fresh everything was. Now at week 4, doing 5 sets of 15, 3x/day, with PT pushing me. I try to push into the 5/10 pain range per rep (not standard, PT wanted us to get aggressive on getting range going, I may have mistranslated their intention lol).

Current ROM: 70° with PT assist. Manual/protocol target for week 4 is 90°.

One wrinkle: my surgeon had to cut close to my VMO for one of the lesions, and that's about where I'm feeling the stiffness/pain that seems to be capping my bending. Can't tell if that's just a slower recovery day-to-day thing I'm failing at or if a VMO-adjacent incision is a known ROM delay.

Questions for the sub if you'd be so kind to share thoughts:

1. Anyone else have their incision near the VMO? Did it noticeably slow your bending progress compared to a more standard incision placement?

2. For those who didn't get a CPM, how'd your ROM timeline compare to the "standard" protocol numbers? Did you stay on target?

3. Is skipping the CPM machine now common?

Trying to figure out if I'm just having a rough patch or if I should be pushing harder, or not doing heel slides enough.

I have not yet had MACI as I'm still on the fence, but I have diagnosed cartilage lesions in my right knee- medial patellar facet and trochlear groove. I've been managing well and pain has been minimal so I've put surgery off.

I attended a wedding a week ago and danced A LOT. Both knees were badly inflamed as a result (I'm a year out from ACL surgery on the left). I've gotten swelling down for the most part but there's lingering pain on the medial side of my right knee that wasn't there previously. This is the knee with the cartilage defects.

In your experience, could this be a flare up or could the lesions have gotten worse? I know I know, hard to say without a physical exam and only so little context, but I'm curious if this will work its way out or if I damaged it more.

If this pain persists I'd definitely be in touch with ortho about getting surgery 1 scheduled.

Hi all. Almost 6 months out. Obviously had some set backs along the way (see king history of posts 🤦🏼‍♀️). I got PRP with hyaluronic acid (and they drained about an oz and a half of fluid) in July and it helped for a few weeks but starting last week my knee is crunchy. You can hear it and feel it (both me in the knee and my physio with his hand on it). It’s in the patella area. Physio doesn’t seem excited by it. Surgeon is in the US and I’m in the UK so no answers there.

Anyone have this experience?

Otherwise things are quieting down a bit, less sliding out, less popping, and I’m back doing real workouts again.