When trauma or early arthritis damages the cartilage in your knee, hip, or ankle, joint-preserving cartilage reconstruction can rebuild the surface — keeping your natural joint and delaying replacement. LAOSS surgeons offer the full spectrum, from microfracture to autologous cell-based MACI.
Surgical and non-surgical options at LAOSS.
Cartilage reconstruction is a category of joint-preserving surgery that rebuilds damaged cartilage instead of replacing the whole joint. When the smooth articular surface inside a joint is lost — from a sports injury, a fall, osteochondritis dissecans (OCD), or an early-stage focal arthritis lesion — LAOSS surgeons can often restore that surface and keep your own joint working.
The four techniques we use most are microfracture (drilling tiny holes to recruit healing cells), MACI (Matrix-Induced Autologous Chondrocyte Implantation — your own cartilage cells grown in a lab and re-implanted), OATS (Osteochondral Autograft Transfer — moving a small plug of healthy cartilage-and-bone from a non-weight-bearing area), and osteochondral allograft (a matched donor graft for larger defects). Most are performed in the knee, but the same principles apply to the ankle, shoulder, and hip.
This is a different conversation than knee replacement. Cartilage reconstruction is for focal damage in a joint that's otherwise healthy — typically active patients in their 20s, 30s, and 40s who want to stay running, hiking, lifting, or playing for another two or three decades before a replacement is ever on the table.
This repairs your knee's damaged articular cartilage. That's the cartilage covering and protecting the ends of your bones. Repairing it helps you stay active. This surgery is done with two procedures. They are performed weeks apart.
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Articular cartilage is the slick white surface that lets bone glide on bone. It has no blood supply of its own, which is why it heals poorly when injured. Reconstruction techniques work around that limitation — by recruiting marrow cells (microfracture), transplanting healthy tissue (OATS, allograft), or growing your own cartilage cells outside the body and putting them back (MACI). The right choice depends on lesion size, depth, location, and your activity level.
Cartilage injuries are hard to read from the outside. The joint may swell, catch, or hurt after activity, but the damage itself is invisible without the right imaging — which is why an accurate diagnosis is the gating step before any reconstruction decision.
At LAOSS your first visit includes a focused history (mechanism of injury, prior procedures, activity goals), a hands-on joint exam, and same-day X-ray to rule out bony causes. When a cartilage lesion is suspected, we order an MRI with cartilage-specific sequences — this is what tells us the size, depth, and exact location of the defect, and whether the underlying bone is involved.
Most patients leave the first visit with a diagnosis, a candid read on whether they're a surgical candidate, and a plan — not just another referral. Set up your evaluation to get a clear answer about your joint.
Not every cartilage injury needs surgery. Many patients do well with conservative care, and even when reconstruction is the right call, the specific technique depends on the size and location of the defect. Here's the full menu — and the criteria we use to choose between them.
For smaller lesions, recent-onset symptoms, or patients who aren't yet surgical candidates, we start here.
When conservative care plateaus and the MRI shows a clear focal defect, we match the technique to the lesion.
Cartilage reconstruction is one of the most technique-dependent procedures in orthopedics. The surgeon's case volume, lesion-matching judgment, and arthroscopic skill drive the durability of the repair.
Joint preservation is a long game. We start with the least-invasive option that has a real chance of working, escalate only when it doesn't, and plan every surgery around protecting your joint for the decades that come after it.
Cartilage reconstruction works best for a specific profile — focal damage, healthy surrounding cartilage, an active patient who wants to keep their natural joint. If most of these match, an evaluation is the next step.
These signs typically point toward an in-person evaluation with a cartilage specialist.
Your first visit is built to give you a real answer the same day — including a candid read on whether reconstruction fits your case.
Cartilage takes time to mature. The repair is fragile in the early weeks and gets stronger month by month — which is why protected loading and patient adherence are as important as the surgery itself.
Early on we protect the repair from compressive load while keeping the joint moving. The cartilage is still healing in — pushing too hard now is the most common way to compromise the result.
Load increases on a clear schedule. PT shifts from protection to rebuilding strength, balance, and confidence in the joint.
Light running typically returns around month 4; pivoting and contact sports closer to 9–12 months. We benchmark each milestone before clearing it.
We talk through the risks and benefits with every patient — informed consent is a conversation, not a form.
Every orthopedic operation carries a small set of standard risks. We screen, prepare, and monitor for these on every patient.
Cartilage reconstruction has its own profile of risks tied to how the repair heals. These are part of every pre-op conversation.
Cartilage reconstruction sits at the intersection of sports medicine and joint preservation. At LAOSS, you'll work with board-certified surgeons who do this work routinely — matching technique to lesion, coordinating PT through recovery, and planning every procedure around protecting your natural joint for the long run.
5 stars. Got in same day for a soccer injury, X-ray right there in the office, had a plan before I left. Couldn't ask for more.
Book a visit with a cartilage reconstruction specialist at any of our eight Los Angeles–area offices.
