
Cartilage Regeneration Treatment Decision
Who Is Suitable
for ChondroFiller®?
ChondroFiller® is not right for every cartilage problem. Use this page as a guide before booking; the final decision is made at consultation with Professor Paul Lee after imaging review and clinical assessment.
Reviewed byProf Paul Lee MBBch, FRCS (Tr & Orth), PhDLast reviewed 1 May 2026Quick Answer
ChondroFiller® as an injection is suitable for adults with cartilage wear in the joint, whether a contained focal defect or diffuse wear across the joint surface. There is no upper age limit and no defect-size limit on the injection. It is particularly valuable as a pre-replacement option for active patients in their 60s, 70s and beyond who want to preserve their own joint. Where the pattern of damage is a single contained focal defect in an otherwise healthy joint, the Liquid Cartilage™ surgical regeneration pathway may also be discussed at consultation. Imaging-led assessment is essential before any decision.
Strong Indicators
Good candidates may include
Cartilage wear visible on imaging
Cartilage damage identified on MRI in the knee, hip, shoulder, ankle, elbow, foot, hand or wrist, whether as a contained focal defect or diffuse wear across the joint surface. ChondroFiller® has no defect-size limit as an injection; the scaffold can coat the entire articular surface in a single delivery.
Cartilage damage after injury
Post-traumatic chondral lesions, osteochondritis dissecans (OCD), or cartilage damage following meniscal injury or ligament reconstruction. ChondroFiller® supports cartilage restoration where the wider joint is otherwise sound.
Active patients in their 60s, 70s and beyond
No upper age limit on ChondroFiller® as an injection. It is particularly valuable as a pre-replacement option for active patients who have been told they need a joint replacement but want to try joint preservation first.
Stable joint mechanics
No untreated ligament instability, no significant malalignment, no meniscal deficit driving the wear. ChondroFiller® addresses the defect, but a mechanically unstable joint will keep re-injuring the new tissue.
Realistic expectations
Understanding that ChondroFiller® supports regeneration but does not guarantee it, that improvement builds over six to twelve months, and that some defects respond better than others. ChondroFiller® is not a cure for arthritis.
Willing to follow the rehab plan
Comfortable with activity modification for two to four weeks, optional onward physiotherapy, and a six-week clinical follow-up. New tissue establishes more reliably when the joint is given room to settle.
Where Caution Is Needed
Patients who may need caution
These are not absolute contraindications, but they warrant a careful conversation before treatment. In many of these situations we recommend an alternative pathway.
A single contained focal defect in an otherwise healthy joint
Where the pattern of damage is one well-defined area with strong surrounding cartilage and the patient has good biological capacity for regeneration, the Liquid Cartilage™ surgical regeneration pathway may be the more targeted intervention. We discuss both options openly at consultation.
Untreated joint instability or malalignment
Untreated ACL injury, meniscal deficit, varus/valgus malalignment, or patellar maltracking. Regenerated cartilage on an unstable platform tends to fail. We may suggest correcting the mechanical problem first.
Active infection
Any active infection, in the joint or systemically, is a reason to defer ChondroFiller®. We treat the infection first and reassess.
Unrealistic expectation of guaranteed regeneration
ChondroFiller® supports regeneration, but outcomes vary by defect size, location, surrounding cartilage quality and patient biology. Patients who expect a guaranteed cure, complete pain relief or zero variability are not good candidates for any regenerative treatment.
Immunosuppression or poorly controlled diabetes
Conditions that significantly raise infection risk warrant a tailored discussion. Most patients can still proceed safely with appropriate planning, but the conversation is more careful.
Pre-Treatment Assessment
What we check before recommending ChondroFiller®
Imaging review
Recent MRI is essential — ChondroFiller® is a defect-targeted scaffold and we need to map the cartilage defect before we can recommend it. We can arrange an MRI if you do not have one. X-rays add context on joint space and alignment.
Pattern-of-wear characterisation
Whether the damage is a contained focal defect or diffuse surface wear, plus depth, location, and surrounding cartilage quality. This determines the box requirement (one, two or three) and informs whether the injection is the right pathway or whether Liquid Cartilage™ surgical regeneration may also be considered.
Joint mechanics
Ligament stability, meniscal status, alignment, patellar tracking (for knee cases). A mechanically unstable platform tends to re-injure regenerated tissue. We may recommend addressing instability first.
Conservative-treatment and surgical history
What you have tried — physiotherapy, injections, previous arthroscopy, microfracture, MACI/ACI. Previous procedures do not rule out ChondroFiller®; they shape the recommendation.
Comorbidity and medication review
Immunosuppression, diabetes control, anticoagulation, recent or active infection. Any of these can change the safety profile or the timing of treatment.
Your goals and expectations
What you want from treatment, what counts as a good outcome, over what timeframe. We will not offer ChondroFiller® where expectations cannot be matched to what a regenerative scaffold can do.
Combined Pathways
Treatments we may combine with or recommend alongside ChondroFiller®
ChondroFiller® as an injection is appropriate across the spectrum of cartilage wear, including advanced osteoarthritis. In end-stage disease the emphasis of the injection shifts toward protection of the joint surface and a meaningful delay before joint replacement is needed, rather than full regrowth of new cartilage. We frequently combine it with, or recommend alongside, other pathways depending on the pattern of damage on imaging.
ChondroFiller® and Arthrosamid® in the same session. ChondroFiller® works on the cartilage at the bone surfaces; an Arthrosamid® injection works on the synovial lining of the joint. They target two different parts of the same joint, address two different sources of pain, and can be delivered together in a single session for patients with both forms of trouble.
Where the pattern of damage on imaging is a single contained focal defect in an otherwise healthy joint with good biological capacity for regeneration, the Liquid Cartilage™ surgical regeneration pathway may be a more targeted intervention: it regenerates native cartilage at the defect site through a single keyhole procedure. Other cartilage repair options such as MACI/ACI or osteochondral autograft transfer may also be appropriate. Where the joint surface is no longer salvageable at all, a knee replacement conversation is the honest answer. The imaging review at consultation is what tells us which pathway fits.
Five Questions, Three Minutes
Take the ChondroFiller® pathway self-assessment
A short questionnaire that maps your goals and joint history to one of four ChondroFiller® pathways — Prevention, Regeneration, Combination or Support. Use it before booking a discovery call so we start from a shared understanding.
Suitability for ChondroFiller®
Frequently asked questions
Who is the ideal candidate for ChondroFiller®?
The ideal candidate is an adult with a focal cartilage defect identified on imaging, stable joint mechanics, realistic expectations about a regenerative timeline, and a desire to preserve the joint rather than replace it. ChondroFiller® works best where the defect is contained, the surrounding cartilage is reasonably healthy, and any underlying instability or malalignment has been addressed.
Can I have ChondroFiller® as an injection if I have bone-on-bone arthritis?
Yes. ChondroFiller® works on the cartilage at the load-bearing surfaces of the joint and coats whatever surface remains, including in advanced osteoarthritis where wear is across the whole joint. In these situations the emphasis of the treatment shifts toward protection of the joint surface and a meaningful delay before joint replacement is needed, rather than full regrowth of new cartilage. There is no upper age limit and no defect-size limit. We may also discuss combining the injection with the Arthrosamid® injection in a single session (Arthrosamid® works on the synovial lining of the joint, so the two treatments address different parts of the same joint), or, where the pattern of damage points to it, the Liquid Cartilage™ surgical regeneration pathway or a knee replacement conversation. Imaging at consultation lets us recommend the right combination for your joint.
Is there an upper limit on the size of cartilage defect?
Not for the injection. ChondroFiller® as an injection has no defect-size limit; the scaffold coats the cartilage surface across the whole joint in a single delivery and is appropriate whether the wear is a contained focal defect or diffuse across the joint surface. Where the pattern is a single contained focal defect in an otherwise healthy joint, the Liquid Cartilage™ pathway — a keyhole-surgery technique that regenerates native cartilage at the defect site — may also be discussed as a targeted alternative. Some cases are better addressed with MACI/ACI or osteochondral autograft transfer. The decision is made at consultation after imaging review.
Can ChondroFiller® treat multiple cartilage defects at once?
Yes. Box pricing reflects this — most patients are treated with a single box for one defect, but two or three boxes can be used to address larger, multi-compartment or bilateral cases in a single appointment. See the ChondroFiller® cost guide for the box-tier breakdown.
What if I have had previous joint surgery?
Previous arthroscopy, microfracture, meniscal repair or ligament reconstruction does not rule out ChondroFiller® — in fact, ChondroFiller® is often considered after these procedures when symptoms persist due to residual cartilage damage. The picture depends on the current state of the joint, not the history alone. Bring imaging and operative reports to the consultation.
Will you tell me honestly if I am not a good candidate?
Yes. We routinely decline ChondroFiller® cases where the chance of meaningful regeneration is low, or where another treatment is the better answer. A clinic willing to say no is a clinic selecting for outcomes. If ChondroFiller® is not right, we will tell you what is — whether that is a different cartilage repair pathway, a long-acting Arthrosamid® injection for symptom relief, or a knee replacement conversation.

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Natural cartilage regeneration starts with the right defect, the right operator, and the right plan.
Learn More about ChondroFiller
Deep dive into our clinical resources and patient guides.
Cost in the UK
ChondroFiller® cost in the UK from £3,000, what is included and why prices vary.
Suitability
Who is suitable for ChondroFiller® as an injection, and who may need caution.
Clinical Evidence
IKDC, Harris Hip Score and MOCART MRI outcomes for ChondroFiller® cartilage regeneration.
Self-Assessment
Five-question ChondroFiller® pathway self-assessment for Prevention, Regeneration, Combination, or Support.
In London
Private ChondroFiller® cartilage repair at our Harley Street clinic.
Liquid Cartilage™ Surgery
Our proprietary keyhole-surgery technique combining ChondroFiller® with MSC co-delivery in a single procedure, for larger or more complex cartilage defects. £9,800.
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ChondroFiller® regeneration compared to microfracture surgery for cartilage defects.
ChondroFiller vs MACI
ChondroFiller® scaffold compared to matrix-induced autologous chondrocyte implantation.
ChondroFiller vs ACI
ChondroFiller® scaffold compared to the original autologous chondrocyte implantation technique.
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ChondroFiller® compared to stem cell and biologic regenerative treatments.
ChondroFiller vs Knee Replacement
Where ChondroFiller® may help preserve the joint and where replacement is the right answer.
ChondroFiller® Injection
Cartilage Regeneration Overview
ChondroFiller® is a registered trademark of Meidrix Biomedicals GmbH. London Cartilage Clinic is not affiliated with or endorsed by Meidrix Biomedicals.