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Microfracture: indications, technique, and results.

Riley J Williams1, Heather W Harnly

  • 1Hospital for Special Surgery, Weill Cornell Medical College, New York, New York, USA.

Instructional Course Lectures
|May 3, 2007
PubMed
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Microfracture surgery stimulates healing in cartilage defects by creating a fibrin clot with mesenchymal stem cells. This technique offers good knee function improvement for many patients with small lesions.

Area of Science:

  • Orthopedic surgery
  • Regenerative medicine
  • Biomaterials science

Background:

  • Cartilage defects are common and can lead to pain and dysfunction.
  • Current treatments aim to restore cartilage function and alleviate symptoms.
  • Microfracture is a widely used surgical technique for cartilage repair.

Purpose of the Study:

  • To review the mechanism, indications, outcomes, and limitations of the microfracture technique.
  • To evaluate the efficacy and long-term results of microfracture for knee cartilage lesions.
  • To discuss factors influencing outcomes and the role of microfracture as a first-line treatment.

Main Methods:

  • Review of clinical studies and literature on microfracture surgery for cartilage defects.
  • Analysis of patient outcomes, including functional improvement and long-term results.

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  • Identification of factors associated with successful and unsuccessful outcomes.

    • Main Results:

    • Microfracture induces fibrocartilage repair by stimulating mesenchymal stem cells from the bone marrow.
    • 70-90% of patients experience improved knee function, particularly in the first year post-surgery.
    • Factors like high BMI and incomplete lesion fill on MRI correlate with poorer outcomes.

    Conclusions:

    • Microfracture is a technically simple, cost-effective procedure for small, full-thickness cartilage lesions (Outerbridge grade 3-4).
    • It provides significant short-term functional improvement and is a valuable first-line treatment.
    • Long-term results vary, and it does not preclude future cartilage repair procedures.