Total Joint Repair

Over the last few years, we have seen an increase in the activity levels of Gen Xers through Gen Zers. CrossFit, kickboxing, HIIT classes, running – you name it; however, all that activity can lead to the break down of the cushioned lining of our joints called articular cartilage. Over time, this breakdown thins the cartilage and can lead to bone on bone approximation of the joints known as osteoarthritis or OA. This is most prevalent in the knee, however, it can be seen in all joints including the ankle, hip, and shoulder.

Total Joint Replacements are seen as a final attempt to regain function and decrease pain for individuals with severe osteoarthritis. This type of surgery is generally reserved for individuals who are 55 years or older as the implant has a general lifespan of 20-25 years. But what happens if you are a 30 year old with significant joint damage or have another illness/disorder that breaks down your cartilage? What are your options then?

Science has come a long way in the last 5-10 years with research on different techniques to help regrow or supplement cartilage growth. Micro-fracturing, stem cell injections, and Protein Rich Plasma (PRP) injections are three such techniques that are seeing more utilization and often require physical therapy to support cartilage growth and health. There has even been utilization of cadaver grafts for cartilage repairs at the knee.

Schedule Appointment | Results Physiotherapy | Total Joint Repair

Causes of Cartilage and Joint Damage

Cartilage can break down over time with repetitive stresses on them such as with running or jobs with a significant amount of standing or weight-bearing through the joint surfaces. It can also be damaged traumatically with excessive forces being applied through the joint while one portion of the limb is stationary such as rotating at the knee while the foot is planted. After puberty, cartilage has a reduction in the blood supply present which limits its ability to heal.

  • Repetitive Stress and Movements
  • Physical Trauma
  • Natural Aging
  • Other Risk Factors
  • Medical Conditions

Symptoms of Cartilage and Joint Damage

Symptoms of joint damage or OA is often pain and stiffness for the first hour of the morning that reduces some with movement, however, prolonged weight-bearing on the joint (i.e. standing, walking, stair climbing, or weight-bearing through the arms and shoulders such as planking or push-ups) can increase symptoms. Pain is generally described as a global, diffuse, deep ache throughout the joint. Unweighting the joint with sitting or taking pressure off usually reduces the intensity of pain and allows to pain to go away.

  • Pain and Stiffness in the Morning
  • Deep Ache Throughout the Joint

Diagnosis of Cartilage and Joint Damage

Clinical diagnosis for joint damage through the use of radiographs, or x-rays, to determine the joint spacing present after injury and between sides. To determine if larger cartilaginous structures such as a meniscus are suspected to be damaged, an MRI may be utilized.

Treatment of Cartilage and Joint Damage at the Orthopedic Level

Several treatment options are making their way to mainstream clinics for the treatment of cartilage and joint damage.

Protein-Rich Plasma (PRP) injections: Blood is taken from the patient and spun down in a centrifuge. Platelets are taken from this solution and injected into the area of damage to help boost the body’s natural response for healing.

Stem Cells Injections: Stem cells are extracted from the patient’s own marrow and re-introduced to the area of damage. The hope is that the stem cells will begin to engineer new cells to match the area of damage.

Micro-fracturing: Small fissures are created on the joint surface in the area of damage to promote the healing and tissue regeneration process. The hyaline cartilage that was damaged is replaced with fibrocartilage to provide a layer of protection over the bone. This technique is often utilized in conjunction with another tissue repair such as a ligament, meniscus, or labrum.

Cadaver Implant: The area of damage is removed from the patient and a graft from a cadaver is implanted into the area. This usually has a combination of bone and tissue graft to allow the bone to fuse together for seamless healing at the site of the transplant.

Tissue Engineering: Recent trials have shown promise with the creation of hydrogel scaffolding that supports the growth of cartilage cells between the openings and provides stability during growth. This is used in conjunction with micro-fracturing.

Treatment of a Total Joint Repair with Physical Therapy

Treatment with the use of PRP and/or Stem cells is often a series of 3 injections over a 2-3 month period. Individuals who have had one of the treatments listed above are often asked to reduce compressive loads for the remainder of the week and to not complete anything strenuous for the following month.

Micro-fracturing and cadaver implants require longer recovery periods and often have several weeks of non-weight-bearing to allow for optimal healing.

For cartilage to grow and be healthy, the joint surfaces need gentle compression and decompression to facilitate cells called fibroblasts to produce proteins that build the scaffolding for the cartilage. Physical therapists will play a key role in your recovery with all of the above options.

Results Physiotherapists and other manual physical therapists can teach protective ambulation/walking and educate on optimal healing conditions, assess and improve joint mobility with specific mobilization and manipulation techniques including decompression techniques, address soft tissue/muscle stiffness or guarding around the painful area.

In addition, licensed Results Physiotherapy physical therapists can help to teach and train improved movement and muscle recruitment patterns to reduce strain on the involved joint(s), improve flexibility and body awareness, help you modify training or work surfaces and modify postures to reduce compressive loads on the joints, teach an individualized home exercise program so you can control your own outcomes, and create an aquatic exercise program to increase strength, reduce pain, and improve overall wellbeing.

Find Location | Total Joint Repair | Results Physiotherapy

Prevention Tips for Cartilage and Joint Damage

There is no guaranteed way to prevent joint or cartilage damage; however, there are more protective habits and movement patterns that you can incorporate into your daily routines to reduce further breakdown. For day-to-day life, having strong and balanced muscles can reduce strain with daily tasks. For those individuals who are weekend warriors or are pursuing a more active lifestyle, shoe options, work surfaces, and protective landing for repetitive tasks can reduce the load on the joints that are taking the repetitive stresses from the activity. All of these can be taught and/or modified for you by a physical therapist, so feel free to call us for an appointment!

Articles Related to Total Joint Repair

References and Additional Research Reading

  1. “The Future of Joint Repair.” The Future of Joint Repair | Arthritis Foundation,
  2. News Center. “Researchers Find Method to Regrow Cartilage in the Joints.” News Center,
  3. “Joint Repair.” Joint Repair Treatment - Brigham and Women's Hospital,
  4. Bone, Muscle and Joint Team. “Joint Preservation vs. Replacement: What's Your Best Option?” Health Essentials from Cleveland Clinic, Health Essentials from Cleveland Clinic, 25 Feb. 2021,
  5. Kraus, Virginia Byers. “Regrow Cartilage in Joints? Science Says You Can.” Healthcare Business News, Trends & Developments, 10 Oct. 2019,
Dry Needling Icon

Request an Appointment


We use cookies to ensure that we give you the best experience on our website. If you continue to use this site, we will assume that you are happy with these terms.