Who is a candidate for cartilage restoration?

Candidates are typically patients with localized cartilage defects (such as osteochondral lesions of the talus) who have pain and swelling but whose joints are not yet severely arthritic. The goal is to preserve the natural joint and delay or prevent the need for replacement.

What is the recovery timeline?

Recovery involves a period of protected weight bearing (typically 4-6 weeks) to allow the biologic scaffold to stabilize and cartilage tissue to begin forming. A guided physical therapy program then helps restoration of range of motion and strength.

How is BioCartilage different from microfracture alone?

Microfracture alone creates a blood clot that heals as fibrocartilage, which is not as durable as natural cartilage. BioCartilage acts as a scaffold that is intended to improve the quality of this repair tissue, aiming for a more durable and functional result.

When can I return to high-impact activities?

The return to high-impact sports like running or jumping is gradual and typically occurs after 6-9 months, depending on follow-up imaging and individual progress in rehabilitation.

Ankle Cartilage Restoration in Canada | Arthrex BioCartilage®

What is Ankle Cartilage Restoration?

Cartilage is the smooth, wear-resistant tissue that covers the bone ends in your ankle joint. Unlike other tissues, cartilage has a limited ability to heal itself. When localized defects occur—often called osteochondral lesions of the talus (OLTs)—they can cause pain, swelling, and a "catching" sensation in the ankle.

Ankle cartilage restoration is a joint preservation procedure aimed at repairing these specific defects. Rather than replacing the entire joint, the surgeon uses biologic materials to fill the gap, providing a structural environment that helps the body grow new, healthy cartilage-like tissue.

Key Goals of Biologic Restoration

Address joint pain and swelling

Improve joint stability

Preserve the natural joint anatomy

Delay or prevent joint replacement

By addressing cartilage damage early with advanced biologics, the aim is to support an active lifestyle and maintain natural joint anatomy.

Advanced Biologics

Arthrex BioCartilage® Technology

Providing a biologic scaffold to enhance the quality of cartilage repair

A Scaffold for Recovery

The Arthrex BioCartilage® kit is a biologic advancement used most commonly on the talus bone. It consists of dehydrated cartilage extracellular matrix that contains the native components of healthy cartilage.

Defect Preparation

Damaged tissue is removed and the bone is stimulated (microfracture) to release healing cells

Biologic Customization

BioCartilage is mixed with the patient’s own blood or bone marrow concentrate (biologic cells)

Direct Application

The biologic mixture is applied directly into the cartilage defect to serve as a repair scaffold

Secure Sealing

A biocompatible sealant is applied over the mixture to help secure the repair in place during initial healing

Arthrex BioCartilage Biological Scaffold

BioCartilage® Biologic Scaffold Mixing & Delivery System

Surgical Approach

Restoring the Talar Dome

Ankle cartilage defects most commonly occur on the talus bone (the "talar dome"). These defects can cause significant mechanical symptoms and, if left untreated, often lead to global ankle arthritis.

The Biologic Process

Healing Stimulus

Microfracture creates tiny channels in the bone to release mesenchymal stem cells
Biologic Mixture

BioCartilage is enriched with your own biological factors to catalyze healing
Precision Filling

The defect is meticulously filled to restore a smooth joint surface

Patient Journey

Planning & Imaging

High-resolution MRI determines the exact size and location of the defect

Day of Surgery

Biologic application typically performed arthroscopically or through minimal open access

Protection Phase (Weeks 1-6)

Non-weight bearing essential to allow the biologic scaffold to consolidate

Activation Phase (Weeks 6-12)

Progressive weight-bearing and specialized physical therapy to stimulate cartilage growth

Return to Activity (6+ Months)

Gradual return to impact sports as indicated by follow-up imaging and clinical assessment

Your Cartilage Restoration Specialist

Fellowship-trained surgeon expert in advanced biologics and joint preservation

Dr. Danny Arora

Minimally Invasive Foot & Ankle Surgery

Duke University Fellowship Trained

View Profile

Frequently Asked Questions

BioCartilage is a biologic scaffold made from allograft (donor) cartilage extracellular matrix. It contains the proteins and factors found in natural cartilage. Once applied, it works with your body's cells to help grow new cartilage-like tissue (fibrocartilage or hyaline-like cartilage) within the defect.

Driving depends on which foot was operated on and your surgeon's specific weight-bearing restrictions. If it was your right foot, you will likely be unable to drive for at least 6 weeks while non-weight-bearing. Your surgeon will give you clearance based on your specific recovery timeline.

For many patients, successful cartilage restoration can significantly delay the onset of global joint arthritis and the need for future joint replacement. The primary goal is joint preservation—keeping your natural joint functional and pain-free for as long as possible.

No referral is required. You can book a consultation directly with our team to discuss your joint preservation options. Having recent imaging (MRI or Weight-bearing X-rays) is highly recommended for evaluation.

Standard microfracture surgery creates a blood clot that heals as fibrocartilage, which is generally not as durable as the original cartilage. BioCartilage provides a scaffold of actual cartilage proteins, which is intended to help the body produce a higher-quality, more durable repair tissue within the defect.

Low-impact activities like swimming and cycling can usually begin after 8-12 weeks. Returning to high-impact sports (running, soccer, basketball) typically requires a gradual progression over 6 to 9 months. This timeline is designed to ensure the new tissue is strong enough to handle sport-specific loads.

References & Disclosures

Technology information regarding the BioCartilage® biologic kit is provided by Arthrex, Inc., the manufacturer. For complete product information, indications, contraindications, warnings, precautions, and adverse events, please refer to the manufacturer's official documentation.

Arthrex BioCartilage®: Arthrex Product Information

Individual results may vary. This information is not intended to replace professional medical advice. Please consult with your surgeon to determine if you are a candidate for cartilage restoration surgery.

Ankle Cartilage Restoration in Canada