Introduction

Knee cartilage injuries are becoming a more common issue, affecting people of all ages and activity levels. Since cartilage is essential for cushioning joints and allowing smooth movement, finding the right treatment is crucial for maintaining mobility and quality of life. Today, patients often face a choice between two main treatment paths: the innovative gel (hydrogel) injections and established surgical methods such as matrix-induced autologous chondrocyte implantation (MACI). This article aims to clarify the benefits and limitations of these options, helping you make an informed decision. The insights here include the expertise of Professor Paul Lee, an experienced orthopaedic specialist at the London Cartilage Clinic, known for its professional, patient-focused care.

Understanding Gel Injections for Cartilage Repair

Injectable cartilage gels, sometimes called hydrogels, are an exciting advancement in treating cartilage damage. These gels are made from materials that mimic the natural cartilage environment and are injected directly into the knee through minimally invasive techniques. The goal is to support and encourage cartilage repair by creating a scaffold for new cells to grow.

Recent research highlights promising results with acellular collagen matrices. For example, one study noted “an improvement in pain symptoms, associated with an increase in force in the pincer and grip movements evaluated with clinical tests.” Although this research was conducted on hand joints, it gives us hope that injectable gels might benefit knee cartilage repair as well.

Many of these gel treatments are still being tested, with some offered only in clinical trials or specialised centres in the UK. One report explains that “cells, scaffold therapies, and injectable agents have emerged as an adjunctive modality to improve clinical outcomes.” Techniques involving a combination of instruments, such as a curette and needle, can help place these gels precisely into the damaged area during arthroscopic procedures.

Specifically for the knee, a clinical study found that “the mean IKDC patient values… after 3rd and 6th months were significantly improved from the preoperative values (p<0.05),” with improvements lasting up to one year. MRI scans demonstrated “a good immediate filling of all treated defects… perfect integration to adjacent cartilage… and impressive maturation of the reconstructed cartilage over time.” The researchers concluded that the gel treatment is “a safe and simple workable method,” though they also stressed that “further studies with larger numbers and longer follow-up are needed” to understand its full potential.

While these injections offer benefits like minimal invasiveness and shorter recovery times, it’s important to remain cautious until we have more long-term data. At the London Cartilage Clinic, Professor Paul Lee and his team approach these treatments carefully, combining the latest evidence with personalised advice.

Surgical Options for Cartilage Repair: Evaluating the MACI Procedure

Surgical methods like the MACI procedure have been a trusted choice for treating cartilage damage. This process involves taking healthy cartilage cells from your knee, growing them in a lab, and then implanting the new cells on a special scaffold into the damaged area.

Surgery is naturally more invasive, usually requiring a hospital stay and a structured recovery period lasting several months. Despite this, MACI has a strong evidence base showing significant pain relief and improved joint function.

Cost, access, and suitability vary depending on the injury’s size and complexity, with surgery often the best option for larger or more difficult defects. Centres such as the London Cartilage Clinic, led by Professor Paul Lee, offer expert assessments to tailor surgery plans to each patient’s unique needs, optimising recovery and outcomes.

Comparing Gel Injections and Surgery: What Should Patients Know?

Here’s a straightforward look at the key differences between gel injections and surgery for knee cartilage repair:

• Invasiveness: Gel injections are minimally invasive and typically outpatient. Surgery requires an operation and hospital stay.
• Recovery Time: Gel injections usually mean less downtime. Surgical recovery is longer, involving careful rehabilitation.
• Evidence: Surgery, including MACI, has a well-established track record. Gel injections show promise but currently lack long-term data. As one expert notes, “despite developing technology, physical examination and clinical history remain the essential, low-cost diagnostic methods.”
• Cost and Availability: Gel treatments often cost less initially but may only be available in specialised clinics or trials. Surgery can be more expensive but is widely accessible in orthopaedic centres.
• Who It’s For: Gel injections suit patients with smaller, less advanced cartilage problems seeking a less invasive option. Surgery is better suited for larger or more complex injuries or where other treatments have failed.

Be wary of health claims describing “breakthrough” treatments without strong scientific backing. Professor Paul Lee stresses the importance of making decisions based on sound evidence, recommending consultation at reputable centres like the London Cartilage Clinic to explore suitable options.

Making the Best Choice for Your Knee Cartilage Health

Both gel injections and surgery have important roles in knee cartilage repair, but the best choice depends on your personal situation— including your injury type, age, activity level and recovery goals.

Seeing an experienced specialist is essential for a thorough assessment and tailored advice. At the London Cartilage Clinic, Professor Paul Lee and his team use the latest research and clinical expertise to support you in making confident and well-informed treatment decisions.

For personalised medical advice, please consult a qualified healthcare professional.

References

• Corain, M., Zanotti, F., Giardini, M., Gasperotti, L., Invernizzi, E., Biasi, V., & Lavagnolo, U. (2023). The Use of an Acellular Collagen Matrix ChondroFiller® Liquid for Trapeziometacarpal Osteoarthritis. Cartilage. https://doi.org/10.1177/19476035251354926
• Perez-Carro, L., Rosi Mendoza Alejo, P., Gutierrez Castanedo, G., Menendez Solana, G., Fernandez Divar, J. A., Galindo Rubin, P., & Alfonso Fernandez, A. (2021). Hip chondral defects: Arthroscopic treatment with the needle and curette technique and ChondroFiller. Arthroscopy Techniques, 10(6), e1471–e1476. https://doi.org/10.1016/j.eats.2021.03.011
• Schneider, U. (2016). Controlled, randomized multicenter study to compare compatibility and safety of ChondroFiller liquid (cell free 2-component collagen gel) with microfracturing of patients with focal cartilage defects of the knee joint. Case Reports in Orthopedics, 5(1). https://doi.org/10.5348/VNP05-2016-1-OA-1