Introduced over two decades ago, microfracture surgery has proven to be a successful method for those with damaged cartilage in the knee to return to their daily activities or sports without pain. Seventy-five to eighty percent of those that go through microfracture surgery show an improvement in these activities.
Microfracture surgery is an arthroscopic procedure that provides an enriched environment for tissue regeneration on the chondral surface through the body's own healing abilities. When a procedure is done arthroscopically it means that a surgeon will visually assess the problem via a small camera insertion and then performs the procedure with special instruments that are inserted in the knee through tiny incisions.
Indicators
If you are experiencing any of the following symptoms, it may indicate that you have a condition that could be treated with microfracture surgery.
- Swelling. The swelling may occur intermittently due to loose fragments floating in the knee.
- Pain.Any discomfort or pain caused by prolonged walking or stair climbing may be an indicator.
- Giving way.When weight is placed on your knee from everyday exercises, it may buckle or fold under the pressure.
- Catching or locking.If you feel your knee catch or its motion become limited, floating pieces of cartilage may be catching in the joint.
- Noise.The motion of your knee can create a noise called crepitus, often described as "snap, crackle, pop."
Treatment
After an evaluation by an orthopedist, the microfracture procedure may be chosen. However, this depends on age, activity level or the general alignment of your knee. Here is an overview of what you can expect from the treatment:
- Unstable cartilage is removed from the exposed bone.
- Remaining articular cartilage is checked on the surrounding rim of the bone for cartilage that is loose or slightly attached. If there is loose cartilage, it is removed leaving a stable edge around the defect.
- Holes, or microfractures, are made in the exposed bone, three to four millimeters apart. The blood and marrow cells from the holes create a clot that covers the damaged area and becomes the basis for new tissue formation.
- A rough bone surface is produced by the microfracture technique that the clot more easily adheres to; eventually the clot matures into firm tissue that becomes smooth and durable.
Typically, you can expect a two to six month window before experiencing improvement in the pain and functioning of your knee. Progress can continue for up to two to three years as well. Overall, microfracture surgery is an effective and reliable procedure that can reduce pain and improve your daily life.
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