OBJECTIVES: To determine surgical treatment outcomes in patients with cartilage defects according to operative procedures performed. METHODS: In this 5-year retrospective cross-sectional study patients were contacted who had been diagnosed with and, if necessary, treated for knee cartilage defects by arthroscopy at one of seven centres in Germany. Patients were assigned to the initial operation (IO) group if the study physician was able to confirm that the study arthroscopy was the patient’s first surgical procedure ever on that particular knee. All other patients were assigned to the re-operation (RO) group. Patients were interviewed on their postsurgical outcome with two disease-specific (Tegner Scale and IKDC Subjective Knee Form [IKDC-SKF] including a retrospective assessment of their pre-surgical health state) and a generic instrument (SF-36). RESULTS: Data from a total of 1708 patients were included in the final analysis. Of these, 1070 were assigned to the initial operation (IO) group (61% men, 49±15 years; 39% women, 52±14 years) and 638 were assigned to the re-operation (RO) group (64% men, 44±13 years; 36% women, 47±14 years). Participants experienced a level reduction of 1.5 (IO) and 2.5 (RO) resp. with the Tegner scale. Patients reported a functional knee status measured by the IKDC-SKF of 64% to 84% dependent on the surgical procedure performed. Significantly lower scores than the general population were observed with the SF-36 for the physical functioning, role-physical, and role-emotional scales, as well as for the physical health summary measure. The strongest limitations in the overall study population compared to the general population were seen on the physical functioning, role-physical, and role-emotional dimensions. In all three instruments the RO group experienced more severe reductions in quality of life. CONCLUSIONS: Despite extensive treatments participants experienced lasting reductions in quality of life. Surgical procedures differ in their long-term outcome. Longer history of interventions decrease the treatment related outcomes.