What is cartilage restoration?
Cartilage restoration is a group of techniques that repair or regenerate a focal area of damaged articular cartilage — the smooth surface capping the bones in the knee. Because this tissue has no blood supply and cannot repair itself, surgery aims to restore a functioning gliding surface.
It is best suited to a defined, isolated defect in a younger, active patient — not to widespread arthritis. Treating the defect early can preserve the joint and help delay the onset of arthritis.
Who is it for?
The ideal candidate has a focal cartilage injury rather than generalised wear:
- A single, well-defined cartilage defect.
- A younger, active patient with otherwise healthy cartilage.
- A stable knee with good alignment (or one that can be corrected).
- Symptoms of pain and swelling localised to the defect.
The techniques
The right technique depends on the size, depth and location of the defect:
Microfracture
Tiny holes in the bone recruit the body’s own repair cells to fill a small defect with new tissue.
OATS / mosaicplasty
Healthy cartilage-and-bone plugs are transferred to resurface the defect with true cartilage.
ACI / MACI
Cartilage cells are harvested, cultured and re-implanted to grow new tissue tailored to a larger defect.
With realignment
Where alignment overloads the defect, an osteotomy may be combined to offload and protect the repair.
Recovery timeline
Cartilage repairs demand patience — the new tissue must mature and bond before it is fully loaded.
Protect
Limited weight-bearing and a brace to shield the healing surface; gentle motion to nourish the cartilage.
Load & move
Gradual return to full weight-bearing and range of motion.
Strength & return
Progressive strengthening, then a graded return to impact and sport as the repair matures.
Risks & outcomes
In well-selected patients, cartilage restoration relieves symptoms and protects the joint, with the goal of delaying arthritis. The main considerations are the patience recovery demands and that not every repair matures perfectly. General surgical risks such as infection, stiffness and clots are uncommon and actively managed.