Articular Cartilage Surgery
What Is Articular Cartilage Surgery?
Articular cartilage surgery refers to a family of procedures designed to treat damage to the smooth cartilage lining the ends of the bones in the knee joint. Because this cartilage has very little ability to heal on its own, surgery aims to either stimulate the growth of new repair tissue or restore the joint surface using cartilage cells or tissue grafts, depending on the size and location of the defect.
When Is Articular Cartilage Surgery Needed?
This surgery is generally considered for patients with:
- A focal (localized) area of cartilage damage causing pain, swelling, or catching
- Symptoms that haven’t improved with activity modification and physical therapy
- A cartilage defect identified on MRI or during arthroscopy that is not simply widespread arthritis, but a more contained area of damage
- A desire to remain active in sports or physical work, where an untreated cartilage defect could progress over time
How Is Articular Cartilage Surgery Performed?
The specific technique depends on the size and depth of the cartilage defect:
- Microfracture — small holes are made in the underlying bone beneath the damaged cartilage, allowing bone marrow cells to form a blood clot that matures into a repair tissue called fibrocartilage. This is best suited to smaller defects.
- Osteochondral autograft/allograft transfer — a plug of healthy cartilage and the underlying bone is transferred from a less weight-bearing area of the patient’s own knee (or from a donor) into the damaged area, restoring a more natural cartilage surface.
- Cell-based cartilage restoration, such as MACI, in which a patient’s own cartilage cells are grown in a lab and later implanted into the defect (see our dedicated MACI Knee Treatment page for more detail).
All of these techniques can be performed arthroscopically or through a small incision, depending on the size and location of the defect being treated.
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Recovery After Articular Cartilage Surgery
Cartilage procedures generally require a more gradual, protected recovery than many other knee surgeries, since new cartilage tissue needs time to mature and isn’t ready for full loading right away:
- A period of limited or protected weight-bearing, often using crutches, for several weeks
- Continuous passive motion or structured range-of-motion exercises to help nourish the healing cartilage
- Physical therapy progressing gradually over several months
- Return to high-impact sports is typically delayed longer than with many other knee procedures — often 9 to 12 months — to give the new cartilage tissue time to fully mature and withstand repetitive loading
Get back to what moves you
Dr. Palsis specializes in the treatment of knee, shoulder, and sports injuries.