For many years, the prevailing belief in medicine was that cartilage hardly ever heals. This idea, grounded in the unique biology of cartilage, has greatly shaped how doctors treat joint injuries and the expectations they set for patients. Traditionally, cartilage damage was seen as largely irreversible because of the tissue’s limited ability to repair itself naturally. However, recent scientific advances and clinical experiences are challenging this long-held view, opening new doors in the field of cartilage regeneration.

Leading this change is Professor Paul Lee, a respected cartilage expert and ambassador for MSK Doctors—a specialist clinic dedicated to musculoskeletal health. With his combined expertise in surgery and medical engineering, Professor Lee is pioneering cutting-edge treatments that aim to improve cartilage healing. This article explores how our understanding of cartilage has evolved, presents promising new therapies, and explains what these developments mean for patients and healthcare professionals alike.

Rethinking the Old Belief: Why Saying Cartilage “Hardly Heals” No Longer Tells the Full Story

For many years, cartilage was thought to have almost no capacity to heal itself. This belief stemmed from two main facts: cartilage has no direct blood supply—which means nutrients cannot reach it easily—and the specialised cells within cartilage called chondrocytes are mostly inactive in adults. Because of this, any injury to cartilage was seen as permanent, often healing with weak scar tissue rather than fully restoring the original healthy tissue.

However, research in recent years has added important nuance to this story. While spontaneous self-repair is limited, it isn’t completely absent. It’s crucial to distinguish between “repair” and “regeneration.” Repair generally produces fibrous scar tissue that does not match the strong, smooth cartilage originally present. Regeneration, on the other hand, involves growing new cartilage that closely resembles the natural, resilient tissue.

Excitingly, recent clinical studies have demonstrated that novel treatments can tap into this regenerative potential. As one report noted of a liquid collagen-based approach: “good clinical and radiological outcomes in a 2-year follow-up in patients with femoroacetabular impingement and grade IV acetabular 2–4 cm² chondral defects” (De Lucas Villarrubi et al., 2021). This highlights that cartilage regeneration is becoming more than just wishful thinking.

The Science Behind Cartilage Health: Synovial Nutrition and the Joint Environment

To appreciate the potential for cartilage regeneration, it helps to understand how cartilage stays healthy in the first place. Unlike most tissues, cartilage doesn’t have its own blood vessels to provide nourishment. Instead, it relies on synovial fluid—the clear, viscous fluid within joints—to deliver nutrients. This process, known as synovial nutrition, is vital for cartilage cells.

Synovial fluid carries essential nutrients and biochemical signals that support cartilage maintenance. In addition, the movement and mechanical loading of joints—basically, the forces and pressures created when we move—provide important stimuli that help cartilage stay healthy and may even encourage repair.

Together, these biochemical and physical factors create a delicate micro-environment that determines cartilage health and its ability to regenerate. Professor Paul Lee’s experience highlights how specialised clinical knowledge is crucial to optimising these conditions and designing effective treatments that encourage cartilage to rebuild itself.

New Treatment Approaches: Combining Science, Scaffolds and Biological Boosters

Building on our improved understanding of cartilage biology, new regenerative therapies blend science and technology in remarkable ways. One leading example is Professor Lee’s Liquid Cartilage™ Procedure (LLC Protocol). This treatment uses a collagen-based hydrogel scaffold called ChondroFiller™, combined with the patient’s own healing agents such as platelet-rich plasma (PRP) and biologically active cells. Sometimes medicinal signalling cells (MSCs) are also added to enhance regeneration.

This gel is carefully injected into the cartilage defect during a minimally invasive arthroscopic surgery, where it quickly forms a supportive, three-dimensional structure. This scaffold encourages the body’s own cells to migrate into the damaged site and develop into new cartilage-like tissue. The treatment also includes measures like stabilising clot formation with tranexamic acid and providing nutritional support to help the repair process.

Importantly, treatments like this represent a shift from merely patching damaged cartilage to “regeneration by design”—using precise combinations of biology and mechanics to encourage genuine tissue renewal.

While some products marketed online, such as the widely discussed ‘magic German gel,’ often lack solid scientific proof, the LLC Protocol is backed by evidence and professional clinical application at MSK Doctors. Patients receive careful advice and realistic information, avoiding false promises.

Recent studies affirm the safety and effectiveness of these therapies. For example, in patients treated with a similar collagen matrix, “patients’ satisfaction was 86.6%… all patients who practiced sports resumed them,” underscoring meaningful functional recovery (De Lucas Villarrubi et al., 2021).

Turning Laboratory Discoveries into Real-World Patient Care

Translating laboratory advances into successful patient treatments requires detailed assessment and careful management. Each patient’s unique condition must be evaluated thoroughly to decide the most suitable approach.

Under Professor Lee’s clinical leadership, treatment plans are tailored individually. Rehabilitation is carefully staged, beginning with protecting the joint and gradually progressing to strengthening and controlled loading to support the regrowing cartilage properly.

Clinical outcomes have been encouraging. In one study, “95% of the patients achieved a clinically important improvement… and 100% reached a satisfactory symptomatic state,” demonstrating real benefits following treatment (De Lucas Villarrubi et al., 2021).

Despite these promising results, cartilage regeneration remains complex. Continuous research and clinical trials help refine these therapies to ensure the best possible patient outcomes.

Conclusion: Cautious Optimism Rooted in Science and Care

Cartilage regeneration is no longer simply an aspiration for the future; it is becoming an achievable goal for many patients. Innovative treatments such as Professor Paul Lee’s Liquid Cartilage™ Protocol offer promising, low-risk options that go well beyond conventional repair methods.

At the same time, cartilage regeneration is a challenging and still-developing field. Careful patient selection, ongoing research, and expert clinical support are vital to success.

MSK Doctors and Professor Lee remain dedicated to providing thorough, evidence-based advice and personalised care. Patients interested in these new treatments are encouraged to be well informed and to maintain realistic expectations.

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

References

De Lucas Villarrubi, J. C., Méndez Alonso, M. Á., Sanz Pérez, M. I., Trell Lesmes, F., & Panadero Tapia, A. (2021). Acellular Matrix-Induced Chondrogenesis Technique Improves the Results of Chondral Lesions Associated With Femoroacetabular Impingement.