Surgery is considered when it is the right choice for you. Before your operation you will receive a Preparing for Surgery booklet and a detailed guide related to your specific procedure.

Cartilage Restoration Options

Procedure	What It Involves	Generally Considered For
Chondroplasty	Loose or unstable cartilage edges are smoothed to reduce mechanical irritation.	Often the first surgical step for smaller unstable flaps, or as an adjunct to other procedures
Osteochondral autograft	Small cylinders of cartilage and bone are taken from a low-load area of your own knee and transferred into the defect.	Smaller defects, using your own tissue in a single operation
Osteochondral allograft	A matched piece of donor cartilage with its underlying bone is shaped and placed into the defect.	Larger defects, and defects where the bone beneath is also damaged
Cell-based resurfacing	Your own cartilage cells are harvested, grown in a laboratory, and implanted on a membrane in a second operation.	Medium to large defects where the bone underneath is intact

The Knee Has to Be Set Up to Succeed

Cartilage repair does not happen in isolation and there are multiple factors that determine its success. Notably, the alignment of your leg, an intact meniscus to spread load, and stable ligaments are all critical. If there are major deficiencies in these categories, the repaired area may be more likely to fail.

This is why an evaluation for cartilage surgery looks at the whole knee rather than just the defect, and why a realignment osteotomy, meniscus transplant, or ligament reconstruction is sometimes recommended at the same time or beforehand. Addressing these issues gives cartilage restoration a chance to work.

What to Expect After Surgery

Recovery and Return to Activity

Recovery after cartilage restoration is long. Weight bearing is usually restricted for several weeks to protect the repair while it integrates.
Motion often begins early, sometimes with a machine that moves the knee passively, because motion helps cartilage heal.
Return to running and impact activity is typically many months out, and return to sport is often around nine months or more.
The repaired tissue continues to mature well beyond the point where the knee feels good, which is why restrictions are followed even when you feel ready.
Rehabilitation is the single most important factor you control!

Risks to Understand

The repair can fail, and a second procedure is sometimes needed.
Knee stiffness is common early and usually improves with therapy, though occasionally it requires further treatment.
Procedures using donor tissue depend on graft availability which can affect the timing of surgery.
Cartilage restoration does not guarantee you will avoid arthritis later and the goal is to delay progression and improve symptoms.
Other risks include infection, blood clots, and problems related to anesthesia. This will be discussed in more detail prior to surgery.

For how this condition is diagnosed and every treatment option, including nonoperative care, read the full Cartilage Injury guide.