Cartilage Restoration
Chondroplasty, microfracture, cartilage transfer (OATS), and treatment of osteochondritis dissecans (OCD) with Dr. Steven Ward in Tucson and Oro Valley — for damaged areas of knee cartilage that cause pain, swelling, or catching.
Call 520-881-1394Typical ranges for general education. Dr. Ward’s plan for you may differ.
What it treats
Articular cartilage is the smooth covering on the ends of the bones that lets the knee glide. It does not heal well on its own, and damage does not show on X-rays.
- Focal cartilage damage — a single damaged area from an injury, often found along with a meniscus tear, ACL tear, or kneecap dislocation
- Frayed or loose cartilage flaps that catch and irritate the knee
- Osteochondritis dissecans (OCD) — a small piece of bone and its cartilage that loses blood supply and begins to loosen, most often at the end of the femur in teens and young adults
- Osteochondral fractures — pieces of cartilage and bone knocked loose by an injury
Restoration works best for younger adults with a single damaged area. Widespread arthritis is treated differently; see total knee replacement for those options.
Is surgery right for you?
Non-operative care comes first for many people:
- Activity changes to limit painful impact
- Physical therapy to strengthen the thigh and hip muscles
- Anti-inflammatory medication when it is safe for you, and sometimes an injection
- For OCD in growing children: rest from sports, sometimes crutches or a short period of immobilization; many lesions heal on their own, often over 2–4 months
Surgery is considered when pain, swelling, or catching continue, when a fragment is loose or unstable, or when an OCD lesion is large or unlikely to heal because growth is nearly finished. An MRI helps show the size and depth of the damage.
How the surgery is done
Most cartilage procedures are done arthroscopically; some need an open incision. The right technique depends on the size and location of the damage, the bone underneath, and your age and activity level:
- Chondroplasty — smoothing and trimming loose, frayed cartilage
- Microfracture or drilling — making small holes in the bone under the damaged area to bring in healing cells that form repair cartilage; best for small areas in lower-demand patients
- Osteochondral autograft transfer (OATS) — moving a small plug of healthy cartilage and bone from a non-weight-bearing area of the knee into the damaged spot
- Osteochondral allograft — donor cartilage and bone shaped to fill a larger defect, usually through an open incision
- OCD treatment — drilling to encourage healing, fixing a loose fragment in place with pins or screws, removing a fragment that cannot be saved, or grafting the area
Treating the whole knee
Cartilage damage often comes with other problems, such as a meniscus tear, ligament injury, or a kneecap that tracks poorly. Those are usually addressed during the same surgery so the new cartilage has the best chance to last.
Recovery overview
Recovery depends on which procedure is done and where the damage is. These are typical ranges, and Dr. Ward’s plan for you may differ.
Chondroplasty alone
- Recovery is similar to a simple knee arthroscopy
- Regular exercises for several weeks to restore motion and strength
- Most physical activities by 6–8 weeks, sometimes sooner
Microfracture, OATS, or allograft
- Crutches with limited weight for the first few weeks, or longer, depending on the procedure and location
- Early motion, sometimes with a continuous passive motion (CPM) machine
- Strengthening as healing progresses; several months before sports or strenuous activity
OCD surgery
- Crutches for about 6 weeks
- Physical therapy for 2–4 months to regain strength and motion
- Gradual return to sports after about 4–5 months, depending on the procedure and healing
When to call the clinic
Call 520-881-1394 if you notice any of the following after surgery or while you are recovering:
- A fever of 101°F or higher, or chills
- Redness spreading around an incision, or drainage that is cloudy, foul-smelling, or keeps soaking the dressing after the first few days
- New or worsening numbness, tingling, or weakness in the leg or foot once the anesthesia has worn off, or a foot that turns pale, blue, or cold
- Pain that is not controlled by your prescribed medication, ice, elevation, and rest
- Pain, swelling, or tenderness in the calf that is new or getting worse
- The knee suddenly locks and will not fully straighten
It is normal for the knee to be swollen, bruised, and sore for a while, and for the leg to feel numb or weak until a nerve block or spinal anesthetic wears off. Use your crutches, walker, or brace as directed. Call if something feels different from what you were told to expect.
for chest pain, shortness of breath, or trouble breathing. These can be signs of a blood clot in the lungs and need emergency care.
If something does not match the instructions you were given, call the office. Dr. Ward or one of his physician assistants will get back to you.
Related resources
Knee arthroscopy & meniscus resection
Dr. Ward’s knee arthroscopy page, including his meniscus resection rehab protocol.
Open pageKnee post-op hub
Knee arthroscopy and knee replacement packets, rehab protocols, and anatomy guides.
Open pageExercise guides
Printable home exercise programs to use with your physical therapist.
Open pagePhysical therapy locations
Find a physical therapy clinic near you in Tucson and Oro Valley.
Open pageOrthoInfo: Cartilage restoration
Patient education on articular cartilage restoration from the AAOS.
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