I had a cartilage implantation in my left knee. The donor cells came from a healthy part of the joint cartilage. Everything seemed to go fine with the surgery. I had three months of rehab and now -- I have more pain than before the operation. I'm really discouraged. What's next for someone like me?

Most surgeons use a minimum of three months of rehab after a chondrocyte (cartilage) implantation before considering the procedure a failure. Although you've completed that much time in rehab, remember that's the minimum. Sometimes, the body is very slow to recover and needs more time.

If you have diabetes, smoke or use tobacco products, if you are overweight, or have poor circulation in general, you could be at risk for delayed healing. It's possible that you put too much compression too soon during rehab. Backing off a bit may help with the recovery and repair process.

Your surgeon is the best one to advise you. It may be necessary to take a look inside the joint to see what's going on. At the very least, X-rays and a clinical exam are needed. Range-of-motion, strength, and pain pattern will be assessed. An arthroscopic exam may be recommended next. Once the condition of the repaired site is determined, then an appropriate plan of care can be decided upon.

Sometimes, it's just a matter of reshaping the healing area. There could be a frayed edge of cartilage or loose fragment causing the painful symptoms. One of the most common problems after chondrocyte implantation is the overgrowth (hypertrophy) of the bone around the implantation. Shaving down this area is usually very successful in putting an end to patients' painful symptoms.