Cartilage cannot truly heal on its own, but several medical procedures and conservative treatments can slow its breakdown, reduce pain, and in some cases grow new tissue to fill damaged areas. The right approach depends on the size and location of the defect, your age, activity level, and how far the damage has progressed. Options range from joint injections and supplements to surgical procedures that transplant or regrow cartilage cells, each with different durability and recovery timelines.
Why Cartilage Doesn’t Heal on Its Own
Unlike most tissues in your body, cartilage has no blood supply. It gets its nutrients entirely through slow diffusion from the surrounding joint fluid and underlying bone. This means your body can’t deliver the repair cells it normally sends to an injury site. Cartilage also has very few living cells relative to its volume, and the dense structure of the tissue makes it difficult for stem cells or other repair cells to migrate into a damaged area. Once cartilage is lost, your body has essentially no mechanism to replace it without outside help.
Non-Surgical Options That Protect Remaining Cartilage
Hyaluronic Acid Injections
Hyaluronic acid injections (sometimes called viscosupplementation) don’t regrow cartilage, but they can protect what you still have while reducing pain. The injected gel restores the viscosity and lubrication of your joint fluid, lowering friction and absorbing shock that would otherwise grind down cartilage cells. Beyond the mechanical benefit, hyaluronic acid also reduces inflammatory molecules inside the joint and boosts the production of key structural proteins in cartilage, including the collagen types that give it tensile strength. It also slows the activity of enzymes that break cartilage down. Most people notice a significant decrease in knee pain after a course of treatment, though the effect is temporary and requires repeat injections.
Chondroitin Sulfate Supplements
Chondroitin sulfate is one of the few oral supplements with MRI evidence showing a structural effect on cartilage. In a randomized, placebo-controlled trial of 69 patients with knee osteoarthritis, those taking 800 mg of chondroitin sulfate daily had significantly less cartilage volume loss in the knee starting at just six months, with the benefit persisting at 12 months. The effect was particularly strong in the lateral compartment and the tibial plateaus (the weight-bearing surfaces of the shinbone). This doesn’t mean the supplement rebuilds lost cartilage, but it does appear to slow the rate of ongoing loss meaningfully compared to doing nothing.
PRP Injections
Platelet-rich plasma (PRP) injections are widely marketed for cartilage repair, but the evidence for actual cartilage regrowth is weak. A systematic review and meta-analysis found that PRP treatment was not associated with a significant increase in cartilage thickness, and there was no significant difference in overall knee cartilage content between PRP and non-PRP groups. The authors concluded that current literature does not support PRP as a cartilage-regenerating treatment. PRP may still help with pain and inflammation, but if your goal is restoring cartilage structure, it’s not the tool for that based on available data.
Surgical Procedures for Cartilage Defects
Microfracture
Microfracture is the simplest and least expensive surgical option. A surgeon pokes small holes in the bone beneath the damaged cartilage, causing bleeding that brings stem cells to the surface. These cells form a clot that eventually becomes a type of repair tissue called fibrocartilage, which is softer and less durable than the original cartilage. Initial procedure costs run around $5,500 to $7,200 depending on location and healthcare system.
The problem is durability. In a comparative study of over 200 patients, the long-term failure rate for microfracture was 66%. The survival rate dropped below 80% within the first 12 months and below 60% within three years. Microfracture is generally considered appropriate for small cartilage injuries, but for larger defects or active patients, it tends to deteriorate relatively quickly.
Osteochondral Autograft Transfer (OAT/Mosaicplasty)
This procedure transplants small plugs of healthy cartilage and bone from a non-weight-bearing area of your knee into the damaged zone, like filling potholes with intact pavement. The transplanted tissue is real, mature cartilage rather than the fibrocartilage produced by microfracture, which explains why it lasts longer. In the same comparative study, OAT had a failure rate of 51% versus 66% for microfracture. More importantly, the survival rate stayed above 80% for the first seven years and above 60% for 15 years. The mean time to failure was 8.4 years compared to just 4 years for microfracture. OAT works best for small to medium defects because the amount of donor cartilage available from your own knee is limited.
MACI (Matrix-Induced Autologous Chondrocyte Implantation)
MACI is a two-stage procedure. First, a small sample of your own cartilage cells is harvested. Those cells are grown in a lab and seeded onto a scaffold membrane, which is then surgically implanted into the defect. It’s the most expensive option, with initial procedure costs around $14,800 to $16,000 compared to roughly half that for microfracture. Over five years, total healthcare costs averaged about $23,400 for MACI patients versus $14,600 for microfracture patients.
However, the cost gap narrows over time. By years four and five after surgery, annual healthcare costs for microfracture patients actually exceeded those of MACI patients, likely because microfracture repairs break down sooner and require additional treatment. In studies tracking outcomes beyond five years, all patients reported satisfaction with MACI results and no complications were observed. One important factor: larger cartilage defects were significantly correlated with worse outcomes in both pain and symptom scores, so MACI works best when the damage hasn’t spread too extensively. Higher body mass index also correlated with poorer structural quality of the repair tissue on MRI.
Don’t expect immediate improvement. In clinical follow-up, no significant improvement in function scores was observed until one year after MACI implantation. The repair tissue needs time to mature and integrate.
Stem Cell Therapy
Injecting or implanting stem cells (usually harvested from your own bone marrow or fat tissue) is an active area of treatment, though results are mixed. Some clinical trials have shown promising signs: MRI evidence of increased cartilage thickness and decreased bone swelling six months after bone marrow stem cell injection, and improved function scores after fat-derived stem cell injections. When stem cells are combined with scaffold materials like collagen membranes or fibrin glue, outcomes tend to improve, with patients showing clinical improvement over 12 to 24 months of follow-up.
The reality check: when evaluated by cartilage repair standards, 76% of patients treated with stem cells alone still showed abnormal cartilage repair on follow-up examination. As with PRP, high body mass index and large lesion size predicted poor outcomes. Stem cell therapy shows potential, particularly when paired with scaffolds, but it’s not yet a reliable standalone solution for regrowing normal cartilage.
Recovery After Cartilage Surgery
Recovery timelines vary significantly by procedure. After microfracture, most patients begin partial weight bearing within the first week, while osteochondral autograft transfer and allograft procedures typically keep you non-weight-bearing for about six weeks. For all procedures, full weight bearing most commonly begins around six weeks after surgery, though there’s wide variation in protocols.
Return to full activity, including impact sports, is most commonly allowed at six months across all procedure types. Osteochondral autograft transfer tends to have the fastest return, with some patients cleared as early as 4.9 months. Chondrocyte implantation procedures like MACI have the longest return timeline, averaging up to 11.6 months. Expect to spend months in a structured rehabilitation program focused on gradually restoring range of motion, strength, and joint loading before returning to activities that stress the repaired area.
3D-Bioprinted Cartilage
Several commercially available cartilage scaffolds already exist for clinical use, including products that come pre-seeded with cartilage cells and cell-free scaffolds that recruit your body’s own stem cells. None of these currently available products, however, are 3D-bioprinted. True 3D-bioprinted cartilage implants, custom-shaped to fit your specific defect, remain in the laboratory phase. Significant challenges in developing the right printing materials, matching the complex layered structure of natural cartilage, and scaling up production mean this technology is still years from routine clinical use.