Table 2.

Advantages and Disadvantages, Including Risks and Limitations, of the Cookie Cutter Technique

Advantages	Disadvantages, Risks, and Limitations
Cookie cutter enables creation of circumferential stable vertical borders	The cutting tools available may not perfectly match defect borders
Cookie cutting template provides containment of curettage, enabling smooth, focal workflow	The flat profile of the cookie cutting blade may not conform well to highly convex areas of the articular surface (i.e., near the intracondylar notch)
Various cutting tools can be chosen and matched to the contour of the defect	The cookie cutter represents a sharp tool that must be used with caution to avoid risk of subchondral plate violation and collapse
The cookie cutter tool allows for the generation of a perfectly matching MACI membrane to fill the debrided defect	The MACI membrane must be adequately large to enable templating with the cookie cutter, especially in the case of multiple defects and defect sizes

MACI, matrix-induced autologous chondrocyte implantation.