In some cases of cartilage damage, surgery is indicated. This will be the case when there is an actual blockage due to, for example, a piece of detached cartilage. In that case keyhole surgery may be useful. Pain caused by the wear and tear itself cannot be helped by keyhole surgery.
During keyhole surgery, two small holes are made in the knee through which a camera and working instruments are inserted. Loose cartilage flaps can be made smooth.
A so-called 'ice pickingor 'microfracture' can be performed. In this process, the cartilage lesion is cleaned and small holes are made in the underlying bone, through which stem cells nestle in the lesion and new "scarred cartilage" can be formed.
The quality of this new cartilage is, however, not as good as the original cartilage, but it does offer some protection. This scar cartilage takes 4 to 6 months to grow. Especially in the first few weeks, the growth is precarious and the knee should be relieved by wearing a brace and using 2 crutches for 6 weeks.
If the cartilage damage is too great or if the treatment so far is insufficient, further interventions can be performed on an individual basis, such as transplanting one or more plugs of bone with cartilage, implanting biological materials or selectively replacing bone and cartilage with an artificial implant. This is a difficult subject that your doctor will discuss directly with you.
For more information, please contact your treating physician.
