Cartilage Repair Surgery: What You Should Know

While many people with arthritis keep it under control with a regimen of pain relievers, exercises, and hot and cold baths, for some, surgery is a better option. Here's what you need to know if your doctor recommends cartilage surgery for your arthritis:

Who should get cartilage surgery?

In most cases, the best candidates for cartilage restoration surgery are young people who have suffered an injury or have one small area of damage. Older patients and people with extensive cartilage loss generally are not good candidates for this type of surgery.

What kinds of cartilage surgery are there?

Different types of cartilage surgery include:

  • Microfracture. This kind of surgery aims to stimulate new cartilage growth. Using a sharp pointed tool called an awl, the surgeon will drill several small holes in the surface of the joint, close to the damaged cartilage. If all goes well, the drilling causes cells to be released from the bone that help build new cartilage. Similar procedures include drilling, in which drilled holes penetrate the bone to stimulate a healing response, and abrasion arthroplasty, which uses a burr (a tool with a rotatable head) instead of a drill.

  • Autologous chondrocyte implantation. In this two-step procedure, healthy cartilage is removed from a different area of the affected bone. The tissue is cultured and the cells are allowed to increase for several weeks. The new tissue is then implanted into the affected area.

  • Osteochondral autograft transplantation. Cartilage is removed from a different area of the affected bone and implanted directly into the damaged area.

  • Osteochondral allograft transplantation. If the damaged area of cartilage is too large for healthy cartilage to be taken from another part of the patient's bone, doctors may remove tissue from a cadaver, shape it, and press it into place.

What can I expect after cartilage surgery?

Patients will need to stay off the affected area for up to 8 weeks, but should be able to return to sports within a few months. During this time, patients will engage in physical therapy to increase strength and flexibility. But while this kind of surgery is often successful, people need to be aware that over time the cartilage may break down-it's not as strong as the body's natural cartilage. Stiffness in the joint that was operated on may also result from cartilage surgery.


National Institutes of Health, www.nlm.nih.go

University of Maryland Medical Center,

American Academy of Orthopaedic Surgeons,