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@William.
I snapped the cartilage in my knee when I was 17, I fell out of a tree and twisted it badly and it locked. The cartilage had broken in half, flipped back on itself and effectively jammed my knee in a bent position. I hopped about for two weeks and finally had an operation. They drilled three holes, put the cartilage back where it belonged and stapled it together. Ten years on it still plays up, mostly I have to avoid twisting or crouching, putting undue stress on it. On the bike I make sure I keep it warm, and dont turn too big a gear unless I can help it. The best way to climb hills (especially on the fixed) is to keep momentum, stand up and sprint, using my whole body rather than letting the joint do the work.
I've been told I'm lucky to still have the cartilage, if they had removed it (which they nearly did) I would have arthritis by now. I have had crippling pain in the winter, not being able to use it at all and effectively commuting 3 months of the year one-legged, luckily this year has been fine. annoyingly i dont know what i did different.