Overview

Articular cartilage is the smooth, white tissue covering the bone surfaces inside a joint. It allows bones to glide against each other with minimal friction and acts as a shock absorber under load. Unlike most tissues, cartilage has almost no capacity to heal on its own: it has no direct blood supply, and very few cells capable of repair. This means even a relatively small area of damage - from a sports injury, a single high-energy impact, or the early stages of osteoarthritis - tends to persist or slowly enlarge rather than repair itself.

Focal cartilage defects sit in a clinical space between an acute injury and end-stage arthritis. The joint structure is largely intact, but a defined area of the cartilage surface has thinned, cracked, or been lost entirely. The therapeutic goal at this stage is to reduce inflammation, support the remaining cartilage, and slow progression. Autologous biologic options (PRGF, BMAC, nanofat) are used here, delivered in clinic without surgery in most cases, before considering more invasive reconstructive options.

Symptoms

• Joint pain on load or activity, often deep and localised to one area
• Catching, clicking, or mechanical locking sensations
• Joint effusion (swelling) after activity
• Reduced range of motion with stiffness
• Symptoms that fail to settle with rest and anti-inflammatories

Who's affected

• Younger patients with sports-related joint trauma
• Adults with focal cartilage damage on imaging (MRI)
• Patients with early osteoarthritis not yet eligible for joint replacement
• Patients seeking non-surgical or minimally-invasive options

Diagnosis

Diagnosis begins with a clinical examination - localised joint-line tenderness, effusion after activity, and mechanical symptoms (catching, locking) that suggest structural involvement. Plain X-rays are a standard first step but are often normal in focal cartilage disease, because X-rays show bone, not cartilage. MRI is the primary imaging modality for cartilage assessment: it can identify the location, depth, and extent of a chondral or osteochondral defect and grade the quality of the surrounding cartilage. Arthroscopy remains the gold standard for direct visual assessment but is an invasive procedure, usually reserved for cases where MRI is inconclusive or where simultaneous treatment is planned at the same time.

Treatment options

Devices used

Procedures

When to see a clinician

A consultation is appropriate if you have persistent joint pain on load or activity that has not settled with rest, anti-inflammatories, and a period of physiotherapy, and if your imaging shows focal cartilage damage or early osteoarthritic changes. Biologic options work best in earlier-stage disease: the more cartilage that remains intact, the more there is to support. Waiting until symptoms are severe and the joint is globally arthritic narrows the window for regenerative intervention. Contact OrganoGEN with a description of your symptoms and any imaging you have - we will route you to a participating clinician for an assessment.

GESY coverage in Cyprus

Regenerative medicine is not GESY-reimbursable in Cyprus. Endoret® PRGF, Marrow Cellution™ BMAC, and Tulip Nanofat™ procedures are delivered through private clinics on a self-pay basis.

The General Healthcare System covers standard orthopaedic procedures only - including SmartBone® synthetic bone graft for osteochondral defects when used in a GESY-covered indication by a participating orthopaedic surgeon.