Chondroplasty

Chondroplasty is a surgical procedure that helps repair damaged cartilage in your joints, offering relief from pain and improved movement for people with mild to moderate cartilage wear.

Table of contents

• What is Chondroplasty?
• Associated Anatomy
• When is Chondroplasty Recommended?
• How the Procedure Works
• Recovery After Surgery
• Benefits of Chondroplasty
• Risks and Considerations

What is Chondroplasty?

Chondroplasty is a surgical procedure designed to repair and reshape damaged cartilage in a joint^[3]. The procedure involves smoothing degenerative cartilage and trimming any unstable flaps of cartilage^[3]. This treatment addresses areas where the cartilage, the smooth tissue that covers the ends of bones in joints, has become rough or damaged.

Cartilage plays a crucial role in your joints by allowing bones to move smoothly against each other with minimal friction and helping to spread the load applied to the joint^[5]. When this cartilage becomes damaged, it can cause significant problems. Damaged cartilage typically does not heal on its own because it does not have a proper blood supply^[3]. The rough and irregular surface of damaged cartilage causes pain, inflammation of the joint, and difficulty in walking^[4].

Chondroplasty is most commonly performed on the knee joint^[2], though it can also be applied to other joints such as the hip or shoulder^[4]. The procedure is typically carried out using arthroscopy, which is a minimally invasive surgical technique^[2]. During arthroscopy, a small camera called an arthroscope is inserted through tiny incisions, allowing the surgeon to see inside the joint without making large cuts.

• Knee
• Hip
• Shoulder

When is Chondroplasty Recommended?

Chondroplasty may be recommended if you have mild to moderate cartilage wear or a cartilage injury in your joint, rather than widespread or irreparable cartilage damage^[3]. Medical intervention is necessary to correct the condition since damaged cartilage does not heal on its own^[3].

The procedure is often considered for people who experience certain symptoms related to cartilage damage. These symptoms typically include pain deep inside the joint, especially with activity, swelling or stiffness after exercise or long rest periods, locking, catching, or grinding sensations when moving, and instability or the feeling that the joint “gives way”^[22].

If left untreated, cartilage damage can progressively degenerate the bones of the joints, eventually causing arthritis^[4]. Chondroplasty prepares the joint for further cartilage restorative procedures if needed^[3]. The procedure is typically recommended when conservative treatments, such as pain medications, anti-inflammatory drugs, hyaluronic acid injections, or physical therapy, do not provide adequate relief^[4].

How the Procedure Works

Chondroplasty is usually performed as an outpatient procedure using arthroscopy, a minimally invasive technique^[3]. The surgery may be performed with general or regional anesthesia^[4]. Sometimes a nerve block is used during surgery, which means your limb may feel numb immediately after your operation^[5].

During the procedure, your surgeon follows several steps. First, small incisions are made around your knee or affected joint^[3]. An arthroscope, which is a narrow illuminated tube with a camera, is inserted through one of these incisions^[3]. This camera provides an enlarged view of the inside of the joint on a monitor, allowing your surgeon to see the damaged area clearly^[3].

Once the surgeon can see the damage, fluid is pumped into the joint to expand it and improve visualization^[3]. Special tools are then used to remove frayed cartilage or loose fragments^[3]. The damaged cartilage is trimmed and the remaining surface is smoothed using tools such as an oscillating shaver or curved shaver^[2]. A small amount of suction is used on the shaver to remove debris without decreasing the pressure inside the joint^[2].

The goal is to remove unstable cartilage while taking care not to damage healthy cartilage or expose bare bone^[2]. If the damaged cartilage is more severe and bare bone is exposed, a surgical procedure known as microfracture may be performed during the same operation^[5]. Microfracture involves making multiple small holes deep into the bone where cartilage is missing, allowing blood rich in growth factors to flow into the area and form a clot that develops into new cartilage over time^[5].

After the repair is complete, the added fluid is drained out and the incisions are closed with stitches^[3]. The procedure usually takes between 30 and 60 minutes^[4].

Recovery After Surgery

Recovery from chondroplasty is generally faster than traditional open knee surgery because the procedure is performed arthroscopically^[6]. You will typically aim to mobilize on the day of your surgery, possibly with the use of elbow crutches depending on the site of your repair^[5]. You should also be able to go up and down stairs^[5].

Though you may need crutches or other assistance after chondroplasty, you can usually return to normal activities within three weeks^[3]. Most patients with sedentary jobs can expect to be off work for one to two weeks with modified duties, while patients with more active jobs involving prolonged standing, walking, or lifting could require up to eight weeks to return to full duty^[21].

It is normal to feel some pain as the nerve block wears off, and you will be provided with painkillers to help with this^[5]. It is important to take these as prescribed to keep pain to a minimum^[5]. Generally, patients can expect mild to moderate pain for two to four weeks after the procedure^[21]. Pain is usually mild after three weeks and typically returns to baseline six weeks after surgery^[21].

Ice can be helpful to reduce pain and swelling^[5]. You can wrap a bag of ice or frozen peas in a damp towel and apply it to the affected area for 10 to 15 minutes, repeating this every three to four hours^[5]. Your wounds will need to be kept clean and dry^[5].

Your physiotherapist will teach you specific exercises to help you recover sooner^[4]. The exercises you can perform will depend on the site of the repair and any restrictions that your surgeon has requested^[5]. You should regularly follow up with your surgeon to assess your progress^[4].

You should not drive while using elbow crutches^[5]. Typically, patients are able to drive from one to three weeks after the procedure^[6]. You may return to normal activities after a few months with your surgeon’s approval^[4].

Benefits of Chondroplasty

Chondroplasty offers several important benefits for people with cartilage damage. The procedure can significantly reduce joint pain and improve joint function^[3]. By smoothing rough cartilage surfaces, it allows the joint to move more smoothly, reducing irritation and discomfort^[24].

One of the key advantages is that the procedure slows cartilage degeneration^[3], potentially delaying or preventing the progression of arthritis^[24]. This can be particularly valuable for younger or more active patients who want to preserve their natural joint function for as long as possible.

Because chondroplasty is performed arthroscopically, it offers the benefits of minimally invasive surgery. Patients experience fast recovery and immediate relief in many cases^[3]. The procedure is less invasive than traditional open surgery, resulting in smaller incisions, reduced pain, and a faster recovery time^[6]. After healing, you will have three small scars where the surgery was performed, rather than a large vertical scar that would result from open surgery^[6].

Another advantage is that repair or treatment of other abnormalities can also be performed during the same arthroscopy procedure^[3]. This allows your surgeon to address multiple joint problems in a single operation, which is more convenient and efficient for patients.

Risks and Considerations

While chondroplasty is generally considered a safe procedure, as with any surgery, there are some potential risks to be aware of. Instances of slight risks such as scarring or mild pain have been reported^[3].

It is important to understand that while chondroplasty can provide significant relief, it does not regrow cartilage^[8]. The goal of the procedure is to restore smoother joint motion and slow future wear^[22]. In some cases, while a chondroplasty may offer temporary relief for pain due to knee cartilage damage, the procedure does not repair the cartilage lesion and may not be effective in the long run^[23].

For more severe cartilage damage where bare bone is exposed, additional procedures like microfracture may be necessary^[5]. Your surgeon will discuss the best approach for your specific condition and help you understand what to expect from the procedure.