Knee Cartilage Damage and Cartilage Repair Surgery

Knee cartilage damage can make running, squatting, climbing stairs or even getting through a workday uncomfortable. One of the frustrating things about cartilage damage is that the knee can look normal from the outside. You may instead notice swelling after exercise, catching with movement or pain that settles with rest only to return when you become active again.

Not every cartilage injury needs surgery. If symptoms keep returning or start limiting sport, work or everyday movement, assessment can help identify what is happening inside the knee and suitable treatment options.

At Ortho ARC in Brisbane, Orthopaedic Surgeons Dr Blake Fidock and Dr Mirun Thayaparan assess knee injuries and conditions and provide treatment planning based on your symptoms, examination and imaging.

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What is knee cartilage damage?

Knee cartilage damage occurs when the smooth articular cartilage covering the ends of the bones inside the knee is injured or worn. This changes the joint surface and affects how smoothly the knee moves.

Articular cartilage provides a smooth, low-friction surface that helps the knee move comfortably. The knee also contains two menisci, which are pads of fibrocartilage between the thigh bone and shin bone that act as shock absorbers in the joint.

Articular cartilage can be damaged during a single injury or gradually with overuse or arthritis. It has a limited blood supply which also limits its ability to heal once damaged.

Cartilage damage may be described as a cartilage defect, chondral injury, osteochondral defect or degenerative cartilage wear. The type, size, depth and location of the damage can all influence treatment.

What causes cartilage damage in the knee?

Cartilage can be damaged during a single injury or change gradually over time, with common causes including:

Sports injuries
Twisting movements
Falls or direct impact to the knee
Previous ligament injuries such as ACL tears
Meniscus injuries
Trauma or previous fractures around the knee
Repetitive loading through the knee
Previous knee injuries or instability
Osteoarthritis and degenerative joint changes

In younger and active patients, cartilage damage can happen after a sudden injury. In an older adult, it may be linked with arthritis or longer-term joint wear. These situations are not treated in exactly the same way, and is why specialist assessment and accurate diagnosis are important.

What does knee cartilage damage feel like?

Symptoms vary with the location and extent of the damage, but you may notice:

Pain during running, sport or exercise
Swelling after activity
Stiffness after sitting or resting
Clicking, catching or locking
Pain with squatting, kneeling or stairs
A deep ache inside the knee
Reduced confidence when turning or changing direction
Pain that repeatedly returns after activity

These symptoms are not specific to cartilage damage and can overlap with meniscus tears, ligament injuries and arthritis. Ortho ARC review your symptoms, alongside imaging and other investigations to confirm the diagnosis.

Does all knee cartilage damage need surgery?

A cartilage injury does not automatically mean you need an operation.

Non-surgical treatment may include physiotherapy, strengthening, changes to activities that trigger symptoms, gradual load management, weight management and medication for pain if suitable. These treatments do not regrow lost articular cartilage, but they can help reduce symptoms and improve strength and movement.

If pain, swelling or catching continues despite non-surgical treatment, surgery becomes part of the discussion. The type, size, depth and location of the damage, along with your age, activity level, knee alignment, ligament stability, meniscus health and the condition of the rest of the joint, can all influence treatment. This is why two people with cartilage damage on MRI may need different treatment plans.

At Ortho ARC in Brisbane, Orthopaedic Specialists, Dr Blake Fidock and Dr Mirun Thayaparan, provide personalised treatment plans and cartilage restoration procedures that include marrow stimulation, cartilage and bone grafting and cartilage cell techniques.

Types of cartilage repair surgery

There are several ways to treat cartilage damage because no single procedure suits every injury.

Knee arthroscopy
Knee arthroscopy is keyhole surgery that allows the surgeon to see inside the joint. Loose or unstable cartilage can be assessed and treated, and related problems such as meniscus tears may also be addressed.

Chondroplasty or debridement
Rough or unstable areas of cartilage may be trimmed or smoothed to remove loose fragments that are catching inside the knee.

Microfracture or marrow stimulation
Small holes are made in the bone beneath the cartilage defect to trigger a healing response. The tissue that forms is fibrocartilage rather than the original articular cartilage.

The location of pain can provide useful clues, but it does not confirm the cause. This explains why exercises or pain relief aimed at the wrong condition can leave people feeling frustrated.

Cartilage and bone grafting
Osteochondral grafting transfers cartilage together with the supporting bone beneath it. Graft tissue can come from another area of the patient’s knee or from donor tissue.

Cartilage cell procedures
Autologous chondrocyte implantation uses the patient’s own cartilage cells to treat specific cartilage damage. It involves collecting cartilage cells and later implanting the cultured cells into the damaged area.

When to request specialist referral for your knee

Speak with your GP about referral to Ortho ARC if your knee pain, swelling or catching has continued for several weeks, keeps returning after activity or is making sport, work or everyday movement difficult.

Ortho ARC provides assessment and treatment for knee cartilage damage, knee arthroscopy and cartilage repair surgery in Brisbane, with consulting and operating locations at:

Greenslopes Private Hospital
Brisbane Private Hospital in Brisbane City
North West Private Hospital in Everton Park
Westside Private Hospital in Taringa

Have a referral? BOOK YOUR APPOINTMENT

GPs or referrers: REFER YOUR PATIENT

The information in this article is general in nature and is not a substitute for medical advice, diagnosis or treatment, nor establishes a doctor-patient relationship. All surgery carries risk and individual results may vary. Please consult with Ortho ARC Brisbane for personalised advice and treatment planning.

References

Australian Orthopaedic Association. (2020). The Management of knee osteoarthritis. https://aoa.org.au/for-patients/patient-information/knee-osteoarthritis

Healthdirect Australia. (Last reviewed 2023). Knee injuries. https://www.healthdirect.gov.au/knee-injuries

Mayo Clinic. (n.d.). Sports Medicine Research. Knee cartilage restoration. https://www.mayo.edu/research/centers-programs/sports-medicine/clinical-services/knee-cartilage-regenerative-medicine

Royal Australian College of General Practitioners (RACGP). (n.d.). Sports knee injuries Assessment and management. https://www.racgp.org.au/getattachment/bfb3d68e-6a87-4c12-8f21-7e1f2e205f09/Sports-knee-injuries-Assessment-and-management.aspx