Cartilage defects in the knee may cause pain, swelling, and reduce quality of life. One-stage matrix-assisted cartilage repair (AMIC- autologous matrix-induced chondrogenesis) combines microfracture with a collagen matrix, while AMIC+ additionally incorporates bone marrow aspirate concentrate.

To evaluate efficacy and safety, ten studies with 786 patients were included (8 RCTs, 2 NRCTs). Evidence (moderate to very low certainty) indicates that AMIC provides better structural repair compared to microfracture, with comparable or improved functional outcomes and a similar or better safety profile. For AMIC+, superiority over standard therapies could not be established due to the limited evidence base. Key limitations include lack of blinding and insufficient data on long-term effectiveness beyond 24 months.