Knee microfracture surgery is a common procedure used to repair damaged knee cartilage. Cartilage helps cushion and cover the area where bones meet in the joints.
Three types of anesthesia may be used for knee arthroscopy surgery:
The surgeon will make a 1/4-inch surgical cut (incision) on your knee.
These holes release cells in your bones that build new cartilage to replace the damaged tissue.
You may need this procedure if you have damage to the cartilage in the knee joint and under the kneecap.
The goal of this surgery is to prevent or slow further damage to the cartilage. This will help prevent knee arthritis. It can help you avoid the need for a partial or total knee replacement.
This procedure is also used to treat knee pain due to cartilage injuries.
A surgery called autologous chondrocyte implantation is done for similar reasons.
Risks for any anesthesia are:
The risks for any surgery are:
Risks for microfracture surgery are:
Always tell your doctor or nurse what drugs you are taking, including medicines, herbs, or supplements you bought without a prescription.
During the 2 weeks before your surgery:
On the day of your surgery:
Physical therapy may begin in the recovery room right after your surgery. A machine gently exercises your leg for 6 to 8 hours a day for several weeks. This machine is most often used for 6 weeks after surgery. Ask your surgeon how long you will use it.
Your doctor will increase the exercises you do over time until you can fully move your knee again. The exercises may make the new cartilage heal better.
You will need to keep your weight off your knee for 6 to 8 weeks unless told otherwise. You will need crutches to get around. Keeping the weight off the knee helps the new cartilage grow.
You will need to go to physical therapy and do exercises at home for 3 to 6 months after surgery.
Many people do well after this surgery. Recovery time can be slow. Many people can go back to sports or other intense activities in about 4 to 6 months. Athletes in very intense sports may not be able to return to their former level.
People under age 40 with a recent cartilage injury often have the best results. People that are not overweight also have better results.
Cartilage regeneration - knee
McCoy, Hussain WM, Griesser MJ, et al. In: Miller MD, Thompson SR eds. DeLee and Drez's Orthopaedic Sports Medicine. 4rd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap. 105.
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Saris DB, Vanlauwe J, Victor J, Almqvist KF, Verdonk R, Bellemans J, et al. Treatment of symptomatic cartilage defects of the knee: characterized chondrocyte implantation results in better clinical outcome at 36 months in a randomized trial compared to microfracture. Am J Sports Med. 2009 Nov;37 Suppl 1:10S-19S.
Basad E, Ishaque B, Bachmann G, Stürz H, Steinmeyer J. Matrix-induced autologous chondrocyte implantation versus microfracture in the treatment of cartilage defects of the knee: a 2-year randomised study. Knee Surg Sports Traumatol Arthrosc. 2010 Apr;18(4):519-27.
Hurst JM, Steadman JR, O'Brien L, Rodkey WG, Briggs KK. Rehabilitation following microfracture for chondral injury in the knee. Clin Sports Med. 2010 Apr;29(2):257-65, viii.
Vanlauwe J, Saris DB, Victor J, et al. Five-year outcome of characterized chondrocyte implantation versus microfracture for symptomatic cartilage defects of the knee: early treatment matters. Am J Sports Med. 2011 Dec;39(12):2566-74.
Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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