Can knee cartilage damage be treated without surgery?

Who does well without surgery

Non-surgical care is usually the first step when the defect is small or partial thickness, the knee is stable, there is no loose fragment, and symptoms are mostly an ache or occasional swelling. It is also reasonable for people whose activity goals are mainly walking, gym work and recreational sport rather than high-level pivoting.

What the treatment involves

• Strengthening of the quadriceps, hamstrings and hip muscles, which absorb load before it reaches the cartilage
• Load management: trading some running or jumping for cycling, swimming or rowing while symptoms settle
• Weight reduction where relevant, because every kilogram adds load across the knee with each step
• Short courses of anti-inflammatories when appropriate
• Injections for persistent symptoms, such as corticosteroid for a flare, or hyaluronic acid or platelet-rich plasma in selected patients

A structured programme usually needs at least two to three months before judging whether it has worked.

What injections can and cannot do

Injections may reduce pain and swelling and help you get through rehabilitation. The evidence for any injection rebuilding a cartilage defect is limited, so they are mainly a tool for symptom relief. Which injections are offered also varies between clinics.

When surgery becomes a discussion

• The knee locks or catches, suggesting a loose fragment
• Swelling and pain continue despite a proper programme
• The defect is large, full thickness and in a young, active patient
• There is an associated problem, such as an ACL tear or kneecap instability, that keeps damaging the surface

At Aman Hospital in Doha, Dr. Gelber reviews the scan and examination with you and explains whether a non-surgical plan is a sensible start.