The technique of microfracture for the treatment of articular cartilage defects in the knee

Abstract

The premise of the microfracture technique is to stimulate the underlying bone marrow and rely on the stereotyped vascular response to injury to heal a full-thickness defect in articular cartilage. Microfracture is indicated for both traumatic and degenerative lesions. The technique is useful for both unipolar and kissing (bipolar) lesions and in both the primary treatment and revision settings. There are no contraindications to the technique based on the size or location of the lesion. The technique has been shown to result in statistically significant improvement ( P < .05) in pain, swelling, and functional testing. Patient satisfaction is high, and complications are low. The technique is cost effective and does not burn any bridges in regard to future surgery on the knee, if needed. A recent magnetic resonance imaging study of healing after the microfracture procedure showed variable rates of healing, although clinical results were good. Strict adherence to limited postoperative weight bearing and the use of continuous passive motion appear to be as important as the operative technique in obtaining optimal results after microfracture.