There are three little holes in my knee cartilage that are small but go clear to the bone. If I don't have these treated will they get worse?

Defects in the joint surface cartilage can stabilize if they aren't in a location of load bearing. But most of these holes develop as a result of chronic stress and overloading. Small defects might not get worse if the person isn't overly active. Chondral defects in older, more sedentary adults have a better chance of staying the same.

Keep in mind that the cartilage doesn't have a natural blood supply that would set up a repair process. So, although the damage might not get worse, it won't get better on its own. There are marrow stimulation techniques that have been developed to stimulate healing of full-thickness chondral defects. Full-thickness describes your situation where the damage extends down to the surface of the bone underneath the cartilage.

There are different ways to stimulate the bone marrow to produce new chondrocytes (cartilage cells). Drilling into the first layer of bone under the articular cartilage is one. Shaving the surface of the bone called abrasion arthroplasty is another and microfracture is the third method currently in use.

All of these procedures have one thing in common. They are designed to fill the hole or defect with tissue from the bone at the bottom of the defect. This can help set up the repair process needed. A clot forms that eventually turns into fibrocartilage tissue.

Your surgeon is the best one to advise you on the treatment of your knee. The location, size, and type of defect are all important factors to consider when establishing a plan of care.