Matrix-Assisted Autologous Chondrocyte Implantation Versus Microfracture for Cartilage Defects of the Knee: A Systematic Review and Meta-Analysis .

Matrix-assisted autologous chondrocyte implantation (MACI) is gaining attention as a restorative treatment for knee cartilage defects, yet its comparative effectiveness to microfracture (MF) remains debated. This systematic review and meta-analysis synthesizes evidence from seven randomized controlled trials, analyzing outcomes including pain, function (KOOS, IKDC, Lysholm), treatment failure, and adverse events. Studies varied in lesion size, follow-up duration, and funding sources, highlighting a complex landscape of trial designs and methodological rigor. Importantly, lesion size, manufacturer involvement, and quality of evidence assessments underscore key challenges in establishing superiority between interventions.