Cartilagesparing

Cartilagesparing refers to surgical and non-surgical strategies designed to preserve native articular cartilage during the treatment of joint disease or injury. The overarching aim is to maintain as much healthy cartilage as possible, relieve symptoms, and slow the progression of degeneration by avoiding unnecessary cartilage loss during intervention.

The approach is most appropriate for younger patients, for individuals with focal, contained cartilage defects, or for joints that are pre-arthritic but unstable. Core principles include realigning mechanical loads to unload affected cartilage, repairing or replacing damaged surfaces with techniques that conserve surrounding cartilage, and choosing methods that minimize additional cartilage injury during treatment.

Techniques and examples of cartilagesparing approaches include realignment osteotomies to redistribute joint load, and joint-preserving arthroplasty such as unicompartmental knee arthroplasty or hip resurfacing, which replace damaged surfaces while leaving more of the surrounding cartilage intact. For focal defects, osteochondral autograft transfer (OATS or mosaicplasty) and osteochondral allograft transplantation aim to restore a cartilage surface with mature hyaline-like cartilage. Cartilage repair strategies such as autologous chondrocyte implantation may be used to stimulate regeneration while attempting to preserve existing cartilage. Procedures like microfracture and scaffold-assisted techniques can be considered in selected cases to support repair while minimizing further cartilage loss. Debridement or smoothing of irreparably damaged cartilage is performed with caution to avoid unnecessary removal of healthy tissue.

Outcomes vary with defect size and location, patient age, and activity level. Cartilagesparing strategies can delay more extensive joint procedures and preserve biomechanics, but long-term durability is context-dependent and may require future interventions.