Cartilage restoration

You may be a candidate for cartilage restoration if: 

• You have persistent joint pain or swelling that hasn't improved with non-surgical treatment
• Imaging such as X-rays or an MRI shows a focal cartilage defect
• Your joint is stable and properly aligned
• You want to maintain an active lifestyle and protect your long-term joint health 

Our team emphasizes conservative treatment first and recommends cartilage restoration surgery only when it offers clear benefits.

Nonsurgical

Before recommending cartilage restoration surgery, your care team may first try nonsurgical options such as physical therapy, activity changes, bracing or injections to manage pain and swelling.

Surgical

When surgery is appropriate, the procedure recommended for you will depend on the size, location and severity of the cartilage defect, as well as your age and activity level. Common cartilage restoration procedures include: 

• Microfracture: A specialized tool creates multiple small holes in the bone beneath the damaged cartilage. This stimulates a healing response, allowing blood and bone marrow cells to form new cartilage tissue. 
• Drilling: Similar to microfracture, this technique uses a drill to create channels in the injured joint surface. These channels promote blood flow and new cartilage growth, though the approach is less precise than microfracture. 
• Abrasion arthroplasty: Using arthroscopic techniques, damaged cartilage is removed with high-speed instruments to expose the underlying bone and stimulate new cartilage formation. 
• Osteochondral autograft transplantation: Healthy cartilage and bone are taken from a non-weight-bearing area of your own joint and transplanted into the damaged area. This option is typically used for smaller cartilage defects. 
• Osteochondral allograft transplantation: For larger cartilage defects, healthy cartilage tissue from a donor is transplanted into the damaged area to restore the joint surface. 
• Autologous chondrocyte implantation (ACI): In this two-step procedure, healthy cartilage cells are harvested arthroscopically and grown in a laboratory. The expanded cells are then implanted into the damaged area during a second procedure to help regenerate cartilage. 

Rehabilitation is a critical part of cartilage restoration. After surgery, your care team will guide you through a structured recovery process that may include: 

• A period of protected weight-bearing or limited motion to allow the new cartilage to heal
• A structured physical therapy program to restore range of motion
• Gradual strengthening exercises as your joint heals
• Ongoing follow-up visits so your care team can adjust your plan as you progress 

Recovery timelines vary depending on the procedure performed and the size of the cartilage defect. Your care team will walk you through what to expect at each stage.

As with any surgery, cartilage restoration carries some risks, which may include infection, stiffness, swelling or the cartilage not healing as expected. Some procedures also require a longer recovery period or a second surgery, such as with autologous chondrocyte implantation. Your orthopedic specialist will review your specific risks, answer your questions and help you understand what to expect before you decide on a treatment plan together.