Chondroplasty of the knee is a surgical procedure performed to address damaged cartilage within the joint. It smooths and stabilizes the roughened articular cartilage, which acts as the knee’s natural shock absorber. The goal is to reduce friction, alleviate pain, and improve the overall function of the knee joint. Since cartilage has a limited capacity to heal due to a lack of direct blood supply, this minimally invasive intervention manages symptoms and mechanical discomfort.
Understanding Cartilage Damage and When Chondroplasty is Necessary
The ends of the bones in the knee joint are covered by articular cartilage, a smooth, glossy tissue that facilitates low-friction movement. When this tissue is damaged, often due to trauma, chronic wear and tear, or degenerative conditions like early osteoarthritis, it can fray or develop shallow lesions. This surface irregularity, known as chondromalacia, can lead to symptoms like persistent joint pain, swelling, and a sensation of catching or locking within the joint.
Chondroplasty is indicated when the cartilage damage is localized, moderate, and involves unstable flaps or rough surfaces causing mechanical irritation. It is typically chosen over more involved cartilage repair techniques, such as microfracture, when the defect is relatively small and shallow. Chondroplasty focuses on debridement and smoothing the existing damaged surface rather than attempting to regenerate new cartilage tissue. This intervention reduces symptoms by creating a smoother gliding surface, which may slow the progression of further joint deterioration.
The Steps of the Arthroscopic Chondroplasty Procedure
The surgical repair is performed using an arthroscopic technique, which involves making several small incisions around the knee joint. This approach is minimally invasive. A small instrument called an arthroscope, containing a camera and a light source, is inserted through one incision to allow the surgeon to visualize the entire joint interior on a monitor.
To create a clear viewing space and facilitate instrument movement, a sterile fluid is continuously pumped into the joint to expand it. The surgeon then systematically inspects the articular surfaces, menisci, and ligaments to confirm the location and extent of the cartilage damage. Specialized surgical instruments, which are long and thin, are inserted through the remaining small portals to access the damaged area.
The core of the procedure involves debridement, or shaving, of the frayed and unstable cartilage edges. Surgeons use motorized shavers or specialized instruments to trim away the loose tissue and smooth the roughened surface down to a stable base. Some techniques may involve thermal chondroplasty, using radiofrequency energy to treat the damaged area. Once smoothing is complete and loose fragments are removed, the instruments are withdrawn, the fluid is drained, and the small incisions are closed. The entire outpatient procedure typically takes around one hour.
Immediate Post-Operative Care and Recovery Restrictions
The period immediately following chondroplasty focuses on managing pain and reducing swelling. Patients are typically discharged the same day, with instructions to apply ice frequently to the surgical site to limit inflammation. Elevation of the leg above heart level is also advised during the first 24 to 48 hours to further control swelling.
Pain management usually involves a combination of prescription medication for severe pain and over-the-counter anti-inflammatories. Wound care involves keeping the small incisions clean and dry for the first few days; showering is usually permitted after 48 to 72 hours, but soaking the knee is restricted until the incisions are fully healed. Patients are generally allowed to bear weight on the leg as tolerated almost immediately. Crutches or other assistive devices may be used for comfort until a normal walking pattern is regained.
Structured Rehabilitation and Long-Term Outcomes
Following the acute recovery phase, structured physical therapy (PT) is the next phase for regaining full function. The primary goals during early rehabilitation are to restore the full range of motion and prevent muscle atrophy in the quadriceps. Specific exercises to regain knee strength and bend are initiated early on.
Rehabilitation generally progresses through phases. This starts with focusing on range of motion and gentle strengthening in the first few weeks, then advancing to closed-chain exercises, balance work, and functional training around weeks four to six. Athletes returning to high-impact activities may then advance to plyometrics and sport-specific agility drills.
Long-term outcomes depend largely on the extent of the original damage and adherence to the rehabilitation program. Chondroplasty is effective for reducing mechanical symptoms, such as catching and locking, and improving pain. However, the procedure does not regenerate the specialized hyaline cartilage, meaning it manages symptoms rather than curing the underlying condition. While a return to sedentary work may occur within days, a full return to stressful activity or sports is typically expected after four to six weeks.