Patient satisfaction and outcome after microfracture of the degenerative knee

Satisfaction and functional outcome was measured in 81 patients who were treated arthroscopically with microfracture for isolated degenerative lesions of the knee. Average patient age was 49 years (range: 40-70 years) and average degenerative lesion measured 229.5 mm2 (range: 25-2000 mm2). Patients were evaluated at average 2.6-year follow-up (range: 2-5 years). All subjective parameters measured (pain, swelling, limping, walking, stairs, sport level, and activities of daily living) demonstrated significant improvement over preoperative status (P<.003). Lysholm score improved from 53.8 to 83.1 (P<.001), and mean Tegner Activity Scale score improved from 2.9 to 4.5 (P<.05). No significant association was noted between Lysholm improvement and gender or age. Significant improvement in mean Lysholm score was noted for lesions in all three knee compartments. Thirteen patients required repeat arthroscopy within 5 years of initial microfracture for lysis of adhesions. Five patients required revision microfracture to a previously treated lesion or total knee arthroplasty at an average of 23 months (range: 5-36 months) from the initial microfracture. Microfracture is an efficacious surgical option for the treatment of degenerative chondral lesions of the knee. The modest rate of failure and need for arthroscopic lysis of adhesions reflects the challenge of joint-sparing arthroscopic surgery in the degenerative knee.