Once joint cartilage it damaged, it is hard for it to recover. Joint cartilage has no nerves or blood vessels, and is dependant for its nutrition on being bathed with joint fluid which is less nourishing than blood.
Then the cartilage cells themselves are limited in their ability to multiply, differentiate and move into the damaged area.
So modern surgical techniques rely on releasing stem cells into the area by poking holes into the underlying bone marrow, and transferring healthier cartilage from an undamaged area into a damaged one, or by multiplying the cells in a laboratory, perhaps on a matrix, and transplanting them back into the damaged area.