Cartilage Preservation

Cartilage preservation refers to techniques aimed at maintaining the health and integrity of joint cartilage, thereby preventing or delaying the onset of cartilage degeneration and arthritis. 

Cartilage is a specialized connective tissue that covers the ends of bones within joints, providing a smooth surface for movement and acting as a shock absorber.

Several approaches may be employed to help preserve cartilage:

Lifestyle modifications

Maintaining a healthy weight, avoiding activities that place excessive stress on the joints, and adopting joint-friendly exercise routines can help reduce wear and tear on cartilage.

Physical therapy and exercise

Specific exercises and physical therapy techniques can help strengthen the muscles around the joints, improve joint stability, and promote better alignment, thus reducing the load on cartilage.

Nutritional supplements

Some supplements, such as glucosamine and chondroitin sulfate, are believed to support cartilage health and may be recommended for individuals at risk of cartilage degeneration. However, the evidence regarding their effectiveness is mixed.


Intra-articular injections of substances like hyaluronic acid or corticosteroids may provide symptomatic relief for individuals with early cartilage damage or osteoarthritis. Platelet-rich plasma (PRP) injections, which contain growth factors believed to promote tissue healing, are also being investigated for their potential role in cartilage preservation.

Biomechanical interventions

Orthotic devices, braces, and footwear modifications can help redistribute forces across the joint and reduce excessive loading on specific areas of cartilage.

Surgical procedures

In cases where cartilage damage is significant or fails to respond to conservative management, surgical interventions may be necessary to repair or regenerate the tissue. Procedures such as microfracture, extracellular matrix transplantations such as BioCartilage or Cartimax, osteochondral autograft transplantation (OATS), osteochondral allograft transplantation (OCA), autologous chondrocyte implantation (ACI), and matrix-assisted autologous chondrocyte transplantation (MACI) aim to promote cartilage repair and regeneration. In some cases, an osteotomy may be performed in conjunction with cartilage restoration procedure to enhance the repair and overall joint function. Osteotomy is a surgical procedure that involves cutting and reshaping bones. It is often performed to correct deformities or realign bones to relieve pain and improve function. 

Osteotomy can be performed on various bones in the body, including the knee, hip, or ankle. In the context of joint preservation, osteotomy is sometimes used to shift weight-bearing forces away from damaged or arthritic areas of a joint, thereby preserving the joint and delaying or preventing the need for joint replacement surgery.

Overall, cartilage preservation strategies aim to maintain joint function, alleviate symptoms, and delay the progression of cartilage degeneration, ultimately improving the quality of life for individuals at risk of developing arthritis.

Osteochondral Defects

An osteochondral defect, also known as an osteochondral lesion or osteochondral injury, refers to a localized area of damage or abnormality affecting both the articular cartilage (the smooth, protective covering of the bones within a joint) and the underlying bone. These defects can occur in any joint but are most commonly found in weight-bearing joints such as the knee, ankle, and hip.

Osteochondral defects can result from various causes, including acute trauma (such as a sports injury or a fall), repetitive stress or overuse, joint instability, or degenerative conditions such as osteoarthritis. The damage may range from small, focal lesions to larger, more extensive defects involving significant portions of the joint surface.

Symptoms of osteochondral defects may include pain, swelling, stiffness, and limited range of motion in the affected joint. In some cases, individuals may also experience catching, locking, or giving way sensations within the joint.

Diagnosis of osteochondral defects typically involves a thorough clinical examination, imaging studies such as X-rays, magnetic resonance imaging (MRI), or computed tomography (CT) scans, and in some cases, arthroscopic evaluation (a minimally invasive surgical procedure to visualize the inside of the joint).

Treatment options for osteochondral defects depend on various factors, including the size and severity of the defect, the patient’s age, activity level, and overall health. Conservative treatment options may include rest, activity modification, physical therapy, pain management, and use of orthotic devices or braces to offload the affected joint.

In cases where conservative measures are ineffective or the defect is large or symptomatic, surgical intervention may be necessary. Surgical treatments for osteochondral defects may include:


A minimally invasive procedure where small holes are drilled into the bone to stimulate the formation of new cartilage. 

This procedure stimulates the growth of new cartilage by drilling small holes in the bone beneath the cartilage defect, promoting healing through the creation of a blood clot that releases growth factors.

BioCartilage Extracellular Matrix

BioCartilage extracellular matrix provides a reproducible, simple, and inexpensive method to augment traditional microfracture procedures. BioCartilage matrix is developed from allograft cartilage and contains the extracellular matrix that is native to articular cartilage, including key components such as type II collagen, proteoglycans, and additional cartilaginous growth factors. The principle of BioCartilage matrix is to serve as a scaffold over a microfractured defect, providing a tissue network that can potentially signal autologous cellular interactions, and to improve the degree and quality of tissue healing within a properly prepared articular cartilage defect.

Osteochondral Autograft Transfer (OATS) or Allograft Transfer (OCA)

Transplantation of healthy cartilage and bone tissue from another part of the joint (autograft) or a donor (allograft) to replace the damaged area.

MACI (Matrix-induced Autologous Chondrocyte Implantation)

MACI involves growing the patient’s own cartilage cells in a lab and then implanting them into the defect, encouraging the growth of new cartilage.

The choice of treatment depends on the individual patient’s condition, the extent of the defect, and the goals of treatment, with the aim of reducing symptoms, restoring joint function, and preventing long-term complications such as osteoarthritis.