Patients with large and well-localized cartilage and bone loss may benefit from resurfacing of the bad part of the joint. The joint is usually evaluated with an arthroscopic camera and then the region involved is resurfaced. Most commonly "plugs" of cartilage and bone are removed from a part of the knee and placed into these areas.

Occasionally, cartilage cells are removed and sent to a laboratory to be expanded and then reimplanted. For very large cartilage problems on one side of the joint, a cadaveric transplant of cartilage and bone can be used. The surgeon often needs to cut part of the bone to gain proper access to the ankle joint for these procedures. In these cases, screws are used to hold the ankle bones in their proper alignment while healing. Patients are usually admitted to the hospital overnight after these procedures. The recovery period usually involves two to four weeks in a splint and six weeks of crutch use to take weight of the healing ankle.