Cartilage Restoration

What is cartilage restoration?

The articular cartilage in the knee is the smooth, frictionless surface that covers the femur and the tibia. Healthy articular cartilage allows for pain-free gliding of the femur on the tibia. Articular cartilage can be damaged in a distinct injury or from normal wear and tear. Restoring damaged cartilage can relieve pain and improve function.

What causes cartilage damage?

Articular cartilage can be damaged or injured from normal wear and tear, or from a traumatic event. Over time, the damaged tissue can wear down to the bone and create a painful condition called osteoarthritis

What are the symptoms of cartilage damage?

Cartilage damage manifests as an achy, tooth-ache like pain. It is frequently accompanied by intermittent swelling and a painful catching or clicking in the knee.

How is cartilage damage diagnosed?

Focal cartilage defects are diagnosed using a combination of patient history, physical examination, and imaging studies, which include X-rays and MRI.

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How is cartilage damage treated?

Cartilage restoration is a highly individualized intervention and is dictated by the patient’s goals and extent of cartilage disease. These interventions are helpful in focal cartilage defects, not diffuse osteoarthritis. Dr. Dare has extensive experience in treating articular cartilage defects and damage in the knee.  The restoration techniques he may use include:

  • Chondroplasty: Dr. Dare will trim and stabilize frayed and fragmented cartilage in an effort to minimize painful catching and clicking. This technique is most useful in small defects without exposed bone.
  • Microfracture/abrasion arthroplasty: The goal of this intervention is to stimulate the bone in a way that causes it to fill the defect with fibrocartilage. Fibrocartilage is not as durable as hyaline, or normal articular, cartilage and this technique is therefore only used for small lesions.
  • MACI (matrix autologous chondrocyte implantation): this is a 2-stage procedure. Stage 1 is an arthroscopic cartilage biopsy, during which a small piece of cartilage is removed from the knee. These cartilage cells are then expanded in a lab and embedded on a special membrane. In stage 2, this membrane is implanted into the cartilage defect. The cartilage cells then regenerate, thereby reducing pain and improving function. Please visit the MACI website ( for more information.
  • OATS, or osteochondral autograft/allograft transplantation surgery – in this procedure, a plug of both cartilage and bone is harvested from either the patient or a deceased donor and used to fill the cartilage defect. OATS is preferable to MACI when there is damage to both the cartilage and underlying bone.

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