What tests do I need before cartilage restoration surgery?

The clinical examination

Before any scan, Dr. Gelber needs to know where your pain is, what triggers it and whether the knee swells, locks or gives way. The examination checks range of motion, ligament stability, kneecap tracking and leg alignment, and muscle strength. This shows whether the defect on the scan actually explains your symptoms.

Imaging

• Standing X-rays: show the joint space under body weight and rule out more widespread arthritis
• Long-leg alignment X-ray: shows whether weight passes through the damaged side, which may mean an osteotomy is needed alongside the repair
• Kneecap views: assess the groove and tilt if the defect is behind the kneecap
• MRI: measures the size and depth of the defect, shows swelling or cysts in the bone beneath, and checks the meniscus and ligaments
• CT scan: occasionally used to assess the bone or kneecap alignment in more detail

Why so many tests?

Cartilage restoration works most reliably when the method matches the defect and when anything that overloads the area is corrected at the same time. A small, shallow defect may suit microfracture or a membrane technique; a large one or one with bone loss may need a graft. Missing a malalignment or a deficient meniscus can undermine an otherwise good repair.

Arthroscopy as a test

MRI can underestimate or overestimate cartilage damage. In some patients a keyhole look inside the knee confirms the defect's size and quality, and in two-stage cell transplants it is also when a small cartilage sample is taken. Your surgeon will explain if this step applies.

Before your visit

Bring any previous MRIs, reports and operation notes to Aman Hospital in Doha. Older scans help show whether the defect is changing over time.