London Cartilage Clinic
Explore expert articles on cartilage care, regenerative treatments, and practical recovery advice from our specialist team.
An unloader brace shifts pressure away from one damaged knee compartment, but it does not correct alignment; in a 2025 randomised trial, high tibial osteotomy gave better 12-month pain relief than a valgus brace for medial compartment osteoarthritis. ChondroFiller fits only selected focal cartilage defects in a mechanically acceptable knee.
By 6 weeks, Achilles rehab should show a small but clear improvement in pain, function or load tolerance, not complete recovery. If symptoms are worsening, the diagnosis is uncertain, or rupture is suspected, assessment should be escalated sooner; persistent cases usually need progressive tendon-loading exercise rather than rest.
Arthrosamid is not routinely available on the NHS for knee osteoarthritis in the UK, with NICE citing insufficient evidence. Most patients seeking it are likely to need private treatment unless they can access a research pathway.
In real-world studies, intra-articular hyaluronic acid is associated with a later total knee replacement in some people with knee osteoarthritis, by about 9.8 months on average in a 2022 meta-analysis and longer in some repeated-course cohorts. The evidence shows delay, not reliable prevention of surgery.
Large focal knee cartilage defects are usually treated according to what is lost beneath the surface: AMIC suits medium-sized cartilage-only lesions, MACI is used for larger focal defects with little bone involvement, and fresh osteochondral allograft is preferred when cartilage and subchondral bone both need replacement.
OATS generally offers more durable preservation than microfracture for symptomatic focal knee cartilage defects, because it restores native hyaline cartilage on bone rather than fibrocartilage repair tissue. When varus or valgus malalignment is driving overload, high tibial or distal femoral osteotomy is often the key corrective step.
