Knee cartilage surgery

Knee cartilage surgery is a procedure that repairs damaged cartilage in your knee. Your cartilage is the slippery coating around the surface of the joints in your knee that acts as a shock absorber for your bones, allowing them to move smoothly between each other. If it gets damaged or torn due to constant wear and tear or a traumatic injury, it can become degraded (known as a lesion), meaning your bones rub against each other, which leads to pain, locking, swelling, or even weakness in the area.

Generally, minor cartilage tears can resolve themselves on their own, or through physiotherapy exercises. If your knee cartilage damage is severe, your consultant may recommend private knee cartilage surgery. There are different kinds of knee cartilage surgeries: some can be minor, with your surgeon only needing to use an arthroscope (keyhole surgery), or you might need your knee joint to be replaced. If left untreated, damaged cartilage can lead to osteoarthritis - a condition that causes the protective tissue around your joint to wear down, causing pain, swelling, and stiffness.

If you would like to know more about knee cartilage surgery, or other treatments for knee issues, our experienced consultants are here to help you. Call 0141 300 5009 or book online today and you could have your initial consultation within 48 hours.

This page takes you through everything you need to know about knee cartilage surgery, including how much it costs, causes, different treatment options, and recovery timeline.

The final cost of knee cartilage repair surgery will depend on various factors personal to you, but we've included some guide prices below to give you an idea.

If you are paying for your own treatment, we offer fixed-price packages so you know exactly what you'll pay ahead of time. This fixed price includes all necessary aftercare and follow-up appointments, but your initial consultation and any diagnostics done at the time will be charged separately.

Self-pay patients can take advantage of our flexible payment options, which allow you to spread the cost of treatment over a period of one to five years, with interest-free options available.

If you have private health insurance, knee surgery will usually be covered by your policy. Speak to your provider directly to find out.

Knee cartilage injuries are fairly common, and their symptoms are generally quite similar.

• Pain in your knee joint (even when you're resting and gets worse when you move around)
• Swelling
• Stiffness and reduced range of movement
• Clicking or grinding sensation in your knee
• Your joint locks, catches, or gives way

You will most likely experience damage to your knee cartilage because of one of three reasons: overuse, injury, or an arthritic condition.

Wear and tear

If you do sports and/or activities that cause constant pressure to be placed on your knee joints (running, football, tennis, etc), you will put strain on the cartilage that protects your bones. This is also something that can happen over time due to old age. If you don't give this area time to rest, your cartilage will wear away and/or become inflamed, leading to pain and stiffness in your knee.

Traumatic injury

Cartilage damage can also be caused by direct trauma to your knee joint. This is especially common in sports, like football or rugby, that require rapid turns at high speed, which puts you at risk of putting immediate severe pressure on your knee joint and subsequent tear/inflammation to your knee cartilage. Other traumatic injuries could be car accidents or a bad fall, where your joint makes direct impact with the ground.

Arthritis

If you have an arthritic condition of any kind, such as osteoarthritis or rheumatoid arthritis (an autoimmune condition that causes cells to attack your cartilage and joints), the cartilage that cushions your joints degenerate over time, leading to your bones rubbing against each other. This causes pain and stiffness, and is more common if you are over 50.

Given that many knee conditions have similar symptoms, with damage usually caused in the same way, your consultant will conduct a thorough examination to assess the exact nature of your knee problem and determine the most appropriate treatment plan for you.

Your consultant will begin by taking a medical history. You will be asked about:

• What caused your knee problem
• Your symptoms
• How long you have had symptoms for
• Whether you've had any past treatment and/or the same issue has occurred before

They will then do a physical examination, with your consultant guiding you through gentle movements to understand the range of movement in your knee. These exercises will show them exactly where and when you feel pain in your knee, which can be useful for understanding where precisely your knee damage is. They will also check for any bruising and/or swelling.

To make sure they get a specific diagnosis, your consultant might order an MRI scan. This scan uses strong magnetic fields and radio waves that produces detailed images of the soft tissues in your body (muscles, tendons, ligaments, and cartilage). So, using this test, your consultant will be able to see the precise location and severity of your knee cartilage damage.

Once your consultant confirms that there are lesions and/or inflammation to the cartilage in your knee, they will initially arrange knee cartilage repair without surgery. There are a number of non-surgical treatments for knee cartilage issues:

Rest

If your knee cartilage issue is not severe, your consultant will start by recommending the RICE method (rest, ice, compression, elevation), along with wearing a protective brace over your knee to prevent you from twisting it any further. Doing this gives the inflammation around your cartilage the chance to heal and may mean that your symptoms go away. Your consultant may also prescribe a series of medications that bring down the inflammation in your knee (NSAIDs).

Physiotherapy

If your knee cartilage issue is not major, and you aren't experiencing high levels of pain, your consultant may recommend a physiotherapy programme. They will prescribe a variety of exercises designed to improve the strength and flexibility of the muscles around your knee joint, which in turn eases the pressure on the cartilage that surrounds your joint. This can be helpful for not just pain but also if you're struggling with mild osteoarthritis.

Preparing for knee cartilage surgery

If your knee cartilage damage is severe and/or conservative treatments have not made a difference to your situation, your consultant may recommend knee cartilage surgery. Ahead of booking you in for a hospital visit, they will give you some information about how to prepare for the procedure.

Make your home recovery friendly

After getting home from hospital, you will need to rest your knee as much as possible for the first week of recovery. So, if you live on the second or third floor, set up a recovery space on your ground floor, as this means fewer trips up the stairs, and take care to remove any tripping hazards (loose flooring, furniture, general mess, etc).

Stop smoking

If you are a smoker, there is an increased risk of you experiencing heart and/or breathing problems during and/or after surgery. Smokers also require higher levels of general anaesthetic, which can cause its own complications. Recovery from surgery can also be hampered if you keep smoking after your procedure. Your consultant may therefore recommend you stop smoking at least a week before coming to hospital.

Stock up on supplies

Because you'll need to keep your leg elevated and rested for the first few days after your knee cartilage surgery, quick trips to the supermarket won't be possible, so be sure to stock up on any supplies you might need before coming to the hospital and have them within easy reach of where you're resting. If you need anything else as you recover, see if a family member or friend can grab it for you.

Check medications with your consultant

Your consultant will speak to you about medications before arranging a time for your surgery. Any medications that thin your blood - aspirin, warfarin, anti-inflammatories - may cause unwanted bleeding during and/or after your surgery, so you might be asked to stop taking them two weeks in advance.

Food and drink

Don't eat or drink anything after midnight on the day of your surgery - apart from small sips of water - and avoid alcohol for 48 hours prior to visiting the hospital.

There are different types of knee cartilage surgery. Your consultant will make a decision on which treatment is most suitable by assessing the severity of your cartilage issue shown on your MRI scan. Whether you have arthritis may also influence what kind of procedure you have.

Knee cartilage repair surgery is done under general anaesthetic, which means you'll be asleep for the full operation and won't feel anything, and typically lasts around an hour.

Microfracture

If your knee injury happened recently and small areas of degradation (lesions) have appeared on your cartilage, your consultant may recommend a microfracture treatment. This involves your surgeon drilling tiny holes into one or more bones in your knee joint, as this allows for greater blood flow in the area, which in turn releases cells that forms new cartilage in the area that has become worn down due to injury. This treatment is not effective if you are older and have severe osteoarthritis and/or have large legions on your joint.

Osteoarticular transfer system procedure (OATS)

Also known as a mosaicplasty, this procedure involves taking healthy cartilage from non-weight-bearing areas of your joint and placing it into the affected area(s). Using a special surgical instrument, your surgeon removes some healthy cartilage from elsewhere in your knee, or potentially the bottom of your upper leg bone (the femur), and prepares it to create two grafts that are inserted next to each other. This creates a new knee cartilage in place of the old protective tissue that became eroded and/or inflamed.

Knee joint replacement

If you have severe arthritis in your knee and less invasive approaches haven't worked, with your knee cartilage problem remaining severe, it may be that you need a knee joint replacement procedure.

Your surgeon will begin the procedure by making an incision from above your knee, which gives them access to your knee joint. Depending on the severity of your cartilage damage, they may need to remove all your knee joint or a part of it. They will then replace the removed joint with a prosthetic knee joint that replicates the performance of your knee. Any worn-out surfaces of your knee are replaced with layers of metal, plastic, or ceramic, which provide a new gliding surface for the bones in your knee.

Generally, you will be able to make a complete return to sports and other activities around six months after your knee cartilage surgery. However, everyone recovers from knee cartilage surgery at a different rate, so your exact timeline may be shorter or longer. The rate at which you recover can be determined by a range of factors, such as:

• The type of knee cartilage surgery you received
• Your fitness levels
• Your everyday activities
• The nature of your job
• General health
• Your age

One to seven days after surgery

After waking up from surgery, you may feel a bit tired, but this is normal as you recover from your general anaesthetic. You'll be given a couple of hours to rest before being discharged from hospital.

When you get home, you may experience some pain, but we'll make sure you are given the pain relief medication that you need. For these first few days, you'll need to walk around on crutches, as well as rest and elevate your knee as much as possible. There will be dressings on your knee that you'll need to keep dry until they're removed after a few days.

One to four weeks after surgery

During this period, you still won't be able to bear full weight on your knee, but your physiotherapist will prescribe a rehabilitation plan that you can start at this stage and eventually brings you back to full strength. This will involve increasing your range of motion through manual manipulation and gentle rotation exercises, ahead of eventually moving to exercises aimed at improving your strength and mobility.

If you have a job that doesn't involve standing or walking (e.g., a desk job), you can probably return to work after a week, although your time out will be more like three months if you are a manual labour worker. You should also be able to start driving again about two to three weeks after your surgery.

One to four months after surgery

A month after your surgery, you should be able to put full weight on your leg, and your physiotherapist - depending on how you've progressed - may encourage you to step up your rehabilitation programme at this point. You may be able to return to physical activity after six to eight weeks, but it will take a few months before you fully recover.

Physiotherapy is especially important following knee cartilage surgery. Rebuilding the muscles around the affected area is crucial for avoiding further damage and ensuring you return to full mobility. Your physiotherapist will work closely with you to provide some tailored knee cartilage surgery rehabilitation exercises.

Complications can sometimes occur with knee cartilage surgery, but these are extremely rare. Your consultant will speak to you about any potential risks and take time to answer any questions and/or concerns you might have before arranging a time for your procedure.

General complications of any operation

• Pain
• Bleeding
• Infection in the surgical wound
• Unsightly scarring
• Blood clots
• Difficulty passing urine
• Chest infection
• Heart attack or stroke

Specific complications of knee cartilage surgery

• Continued joint stiffness and further inflammation
• Haematoma (a collection of blood outside the blood vessels)
• Phlebitis (inflammation of your vein)
• Your grafted cartilage or artificial joint becomes loose, detached, or damaged