Knee Cartilage Surgery: Recovery Times and More

There are two main issues that affect recovery after an injury to the articular cartilage of the knee. First is the fact that cartilage cells, called chondrocytes, are unable to produce normal cartilage to repair damaged areas. Instead, the knee produced a type of scar tissue called “fibrocartilage”, which is not as durable as healthy articular cartilage. Second, cartilage has poor blood supply which further limits healing capacity. These two issues complicate recovery after knee injury and can increase the need for knee cartilage surgery.

There are many different surgical procedures available to address cartilage damage. Selection of the optimal surgical treatment depends on a variety of factors including size of the cartilage injury, location of the cartilage injury in the knee, and how many cartilage injuries are present. Each surgical procedure differs in terms of recovery time, able to bear weight after surgery, whether or not a brace is required, how much physical therapy may be prescribed and when you’ll be able to return to sports and other activities. While these details may differ slightly between surgeons, here is a general overview about the types of surgical procedures, postoperative rehabilitation and overall recovery time.

Does Torn Cartilage in the Knee Require Surgery?

As we’ve mentioned, cartilage doesn’t heal well on its own. If you have persistent knee pain, you may ultimately have to fix the problem surgically. The more severe the injury, the less likely self-healing is going to be successful. Now, the majority of present-day procedures are done arthroscopically, latin for “joint viewing”, where a small camera is inserted into the knee joint to view the internal structures. Other instruments, such has probes and shavers, are inserted through additional small incisions.  This minimally-invasive procedure results in less pain, less scar tissue formation, quicker recovery time and lower risk of infection compared to open surgery.

What Are the Types of Knee Cartilage Surgery?

The phrase “knee cartilage surgery” is an umbrella term and can mean several different things. The five most common surgery types are:

• Chondroplasty: Latin for “cartilage fixing”, this method is used for minor partial-thickness cartilage damage. Here, the surgeon removes loose flaps of cartilage to reduce the sensation of pain in the joint. This knee cartilage surgery is usually carried out arthroscopically and the recovery time is quite short.
• Microfracture: This procedure is utilized for more significant full-thickness cartilage injuries less than 2 cm in size, in older, lower-demand patients. Here, the damaged area is debrided and the bone is punctured to cause bleeding and improve the natural healing of the cartilage. The cartilage which forms after this procedure is scar cartilage called “fibrocartilage” and it is not as durable as normal cartilage or cartilage grown in a lab.
• Osteochondral Autograft Transfer (OATS): This procedure is tailored best for full-thickness cartilage lesions less than 2 cm in size that have underlying bone loss and/or occur in younger more active individuals. Here, healthy cartilage is taken from one area of your joint, which is not critical, and implanted into the area where cartilage is missing or deteriorated.
• Osteochondral Allograft Transplantation (OCA): This procedure is used for larger full-thickness cartilage injuries greater than 2 cm in size that also have underlying bone loss. OCA involves transplanting healthy cartilage tissue from a donor (cadaver) into your knee to fill the cartilage defect. This process requires a longer recovery period, including a longer period of restricted weightbearing and more physical therapy to optimize the result.
• Matrix-induced Autologous Chondrocyte Implantation (MACI): This procedure is reserved for large full-thickness cartilage lesions greater than 2 cm in size that have intact underlying bone. This is a two-stage surgery. At the first surgery, a tiny amount of cartilage (“chondrocyte”) is taken from your knee (thus “autologous”), grown in a lab on a cellular matrix of collagen (“matrix-induced”). At the second surgery, the new cartilage is then implanted into the defect and secured with fibrin glue. This surgery for knee cartilage is quite advanced and requires a longer recovery time as the matrix of cartilage must take root into your bone as normal cartilage does.

Regardless of the surgery type, the success of the method depends on several factors, especially having an experienced and successful knee cartilage surgeon on your side.

What Is the Knee Cartilage Surgery Recovery Time?

You need to keep in mind that any knee cartilage surgery will require some recovery time, including use of crutches and physical therapy, in order to have a good outcome.  Some of the simplest (least invasive) procedures, such as chondroplasty, may take as little as 6 weeks to fully recover; however, the cartilage restoration procedures – OATS, OCA and MACI – take much longer, typically 6 to 9 months for a full recovery.

It’s also worth taking into consideration the nature of the injury in question. Generally speaking, cartilage injuries happen either as a result of traumatic injury or as a result of overuse. The latter can be further amplified by arthritis in your knee. If that’s the case, you’re probably looking at a longer recovery time. You also need specialized surgery to help you get back on track.

What Is the Cost of Knee Cartilage Surgery?

The cost of surgery is another question that’s often raised by patients. Now, there are three things to consider when it comes to the cost:

• Is the procedure covered by my insurance?
• What’s the success rate of the surgery?
• Is there a chance that the cartilage damage can be treated without surgery?

It’s also important to consider the direct costs of the surgery:

• The surgeon fee
• The anesthesia fee
• The facility fee

A positive answer to the first question and a negative one to the third is already great indicators that you might need the surgery in question. The second one depends on too many factors, ranging from the competence of the team performing the surgery, all the way to the severity of the injury. Nonetheless, seeing as how knee cartilage repair without surgery is highly unlikely, surgery is usually worth the cost.

How Long Does Knee Cartilage Surgery Take?

The last thing you need to keep in mind is that the duration of surgery depends on the procedure being performed. Simpler arthroscopic surgeries such as chondroplasty and microfracture taken about 45 to 60 minutes. Cartilage restoration procedures such as OATS, OCA and MACI are open surgeries and therefore typically take roughly 2 hours.

Once again, the severity of the injury will determine the amount of work there’s to be done. To get a more definitive answer on the expected duration of your knee cartilage surgery, ask your surgeon.

Wrap Up

In the end, if you fail conservative treatment, knee cartilage surgery may be required to address the cartilage damage in your knee. Due to the lack of robust blood supply, damaged cartilage is unable to heal itself and therefore requires surgical intervention if pain and dysfunction persist. The recovery time and the cost of the procedure will depend on the type of surgery performed.

To get more specific quotes on your own situation, find a knee cartilage surgeon at the Orthopedic Institute of New Jersey.