Editorial Commentary: Matrix-Associated Autologous Chondrocyte Implantation for Osteochondral Talar Lesions Is Promising yet Premature.

Matrix-associated autologous chondrocyte implantation (MACI) has long been established as a viable option for focal cartilage defects in the knee. Its application in the ankle, however, remains controversial, with inconsistent evidence and substantial variation in outcomes. This commentary reflects on the current status of MACI for osteochondral lesions of the talus, highlighting methodologic weaknesses, uncertain clinical significance, and the need for robust comparative trials. The field needs higher-quality prospective research to generalize the use of MACI to focal cartilage lesions of the talus with the same confidence as in the knee.