Elite athletes, including Tiger Woods, Kobe Bryant, Alex Rodriguez and Dara Torres, are using unconventional treatments with high-tech names to heal their worn-out joints. The goal of most of these therapies is to harness the body’s own healing power to repair damaged cartilage. For some, the results have reportedly been close to miraculous.

But how well do the procedures really work? And can they help non-celebrity joints, too?

Cartilage restoration bridges the gap between symptom relief and joint replacement surgery. Orthopaedic surgeon Jason M. Scopp, MD, director of the Joint Preservation Center at Peninsula Orthopaedic Associates in Salisbury, MD, and a member of the International Cartilage Repair Society’s publications committee, likens it to road repair.

“When cartilage damage occurs, you no longer have a smooth relationship between the bones in the joint. It’s like driving over a pothole in your car,” he says. “In cartilage repair, we’re filling in the pothole so it doesn’t get larger.”

Dr. Scopp is optimistic about the future of the field. “We’re entering an exciting era in joint restoration and preservation, where the older cartilage-repair procedures are being replaced by the newer, biological type. There are many different avenues that are being investigated, and we don’t necessarily know which is the right one, but we know we’re on the right path,” he says.

Others agree that cartilage restoration has great potential, especially for younger, active patients with a small cartilage tear or defect, but the new procedures aren’t for everyone. Orthopaedic surgeon Brian J. Cole, MD, head of the Cartilage Restoration Center at Rush University Medical Center in Chicago, stresses they’re not intended for patients with bone-on-bone osteoarthritis (OA). But, he adds, “At the very least, they may prevent or forestall arthritis in the future.”

Some of these techniques have been around for decades. Others are not yet approved for use in the United States. A few are controversial, especially for treating OA. We asked experts to help separate the science from the hype.

Microfracture Surgery

This is the benchmark by which other techniques are judged, because it was developed nearly 25 years ago. Since then, it has widely been used as a first-line surgical treatment for joint pain, swelling and stiffness. More than 25,000 procedures were performed in 2007 in the United States.