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Effectiveness of Microfracture Augmentation in the Intercondylar Notch on Meniscal Healing: A Retrospective
Ahmad Shakib Mohebi1,2,3, Basira Bek4, Emal Wardak2
1Department of Orthopedic Surgery and Traumatology, Ariana Medical Complex, Kabul, Afghanistan.
Purpose:
This study aimed to evaluate the effectiveness of microfracture augmentation in the intercondylar notch on healing outcomes after arthroscopic meniscal repair, with stratification by meniscal tear type (bucket-handle vs longitudinal).
Background:
Meniscal tears are common knee injuries with variable healing potential. Microfracture augmentation, which involves small perforations in the intercondylar notch to release marrow elements, has been proposed as an adjunct to enhance meniscal repair. However, the impact of this technique across different tear types remains under investigation.
Patients And Methods:
In this retrospective cohort study, 173 patients aged 18-40 years with isolated bucket-handle or longitudinal meniscal tears undergoing arthroscopic repair were included. Patients were divided into two groups: microfracture-augmented repair (n = 87) and non-microfracture repair without augmentation (n = 86). All surgeries were performed by a single senior orthopedic surgeon, and postoperative rehabilitation protocols were standardized. Healing was assessed at 12 months using Barrett's criteria, the Apley Grinding Test, and clinical evaluation. Statistical analyses included chi-square tests, odds ratios, risk ratios, ROC curve analysis, and binary logistic regression to evaluate associations between surgical technique, tear type, and postoperative outcomes.
Results:
Microfracture augmentation was associated with significantly higher overall healing rates compared to non-microfracture repair (88.5% vs 64.0%, p < 0.001). Stratified by tear type, microfracture had the greatest benefit in bucket-handle tears (79.4% vs 37.8%, p < 0.001; OR = 6.353, 95% CI: 2.275-17.737; RR = 3.022, 95% CI: 1.503-6.076), while healing rates were similar for longitudinal tears between techniques (94.3% vs 92.7%, p = 0.745). Age, gender, and side of injury were not significant predictors of outcomes.
Conclusion:
Microfracture augmentation enhances healing after arthroscopic meniscal repair, particularly in bucket-handle tears, while longitudinal tear outcomes are favorable regardless of augmentation. These findings emphasize the importance of tear type in guiding the choice of surgical technique.
