- Most clinical studies report improvement in knee function in 70% to 90% of patients who had microfracture. (17)
- In a study of 80 patients over the age of 50 with osteoarthrosis of the knee, significant improvement was observed in pain and swelling after microfracture. The ability to walk 2 miles, run, climb stairs, perform strenuous work, engage in rigorous sports, and carry out activities of daily living were improved. Seven of the procedures were labeled failures as there was a need for a second procedure. Five cases needed total knee arthroplasties. Although some of the results are encouraging, age does limit the success of the procedure. (7)
- In another study 81 patients treated for isolated degenerative lesions ranging from 40 to 70 years of age and lesions ranging from 25 to 2000 mm in area were followed up with 2 to 5 years post surgery. They were tested for satisfaction and functional parameters. The study found that pain, swelling, limping, walking, stairs, sport level, and activities of daily living showed statically significant improvement over pre-surgery status (P<0.003). Thirteen patients (15.5%) needed a second arthroscopic procedure within 5 years of the initial microfracture procedure to address lysis of adhesions. Five patients (5.9%) needed revision microfracture to a previously treated lesion or total knee arthroplasty at an average of 23 months (range of 5 to 36 months) from the initial microfracture procedure. (12)
- In a study of 32 athletes who participated in high-impact, pivoting sports before suffering an articular cartilage injury were treated with microfracture. During the last follow-up (follow-ups a minimum of two years), 21 of the patients (66%) reported good or excellent results. After initially improving, functional scores decreased in 47% of the athletes. Of the 44% of athletes who were able to regularly participate in high-impact, pivoting sports, 57% of them were at their preoperative level. The chances of returning to high-impact sports was significantly higher in athletes with age <40 years, lesion size < 200 mm in area, preoperative symptoms < 12 months, and no previous surgical intervention. The data from the study indicated that the longer the duration between injury and microfracture, the lower the rate of return to high-impact athletics. This indicates that early surgical treatment of articular cartilage lesions is key for return to preoperative function. (15)
Figure 4- A second-look arthroscopy being performed to check the quality
of the regenerated cartilage
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