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@nomoreknees
Sorry this is a massive digression, but I'm fresh in from the pub and this comes easily.
Who told you it was a cartilage problem?
The NHS are generally pretty shit when it comes to diagnosis of knees problems (and indeed any specific use injury) stemming from cycling. This isn't a criticism of the NHS as they simply don't (and why should they) have access to knowledge of niche activities that may alter their diagnosis.
I talk from experience.
Gearing down may not help, (well actually that depends what gearing you are using now)
What foot retention do you use?
Do you have one leg longer than the other?
If so is it the calf or thigh that is longer?
How long are your legs?
What size cranks are you using?
Do you have High/low arches?
Does one leg bow in/out during pedaling?
If you do stop cycling (you should for a bit, seriously) does your knee feel better?
Any way, Good luck!