Microfracture Surgery

What Is Microfracture Surgery?

In the microfracture procedure, the bone under the cartilage is intentionally injured during an arthroscopic procedure (surgical arthroscopy) in patients with cartilage damage, which results in blood cells escaping from the defective bone, then being converted back into cartilage cells. The newly forming replacement cartilage made of fibrocartilage tissue does not replace the typical joint cartilage but can slow down joint degeneration.

Which Cartilage Defects and Joints Are Suitable for the Procedure?

Generally, microfracture surgery is used as standard therapy for cartilage defects up to a size of 2-4cm2, which are considered small cartilage defects. It can be said that the smaller the cartilage defect, the greater the chances of an excellent surgical result.

Suitable joints for this procedure are, in principle, all those in which arthrosis typically develops due to mechanical overload/improper load. Therefore, microfracture surgery is most often performed on the knee joint and the hip, shoulder, and ankle joints.

What Is the Procedure for Microfracture Surgery?

Microfracture surgery is carried out as part of a minimally invasive arthroscopy (arthroscopy of the joint). A camera and surgical tools are inserted into the joint through two small skin incisions. Pieces of the cartilage are smoothed with a surgical tool, and so-called perforation holes are made on the exposed bone with special surgical instruments. The blood cells can then escape from the now broken (fractured) bone and differentiate into the desired cartilage cells.

How Long Is the Healing Time?

Due to the prolonged regenerative capacity of cartilage tissue, a healing period of up to half a year can be expected.

Depending on the severity of the cartilage damage and the surgeon's instructions, crutches with partial weight-bearing should be used for the initial 4-8 weeks after the surgery to relieve the operated joint pressure. However, initial success in pain relief can occur early on, but sparing is still important to not overload the fresh cartilage scar too quickly.

What Is the Success Rate and What Should Be Paid Attention to After the Treatment?

Improvement of the symptoms can be expected in up to 80% of patients after a successful surgery. However, the long-term success is controversially discussed since the newly formed replacement cartilage does not have normal articular cartilage quality.

A good result is guaranteed by a successful surgical procedure and requires a great deal of patient commitment. Besides strict adherence to relief with crutches for 4-8 weeks, even several hours a day, passive movement via a motion splint must be carried out. It is indispensable to carry out a consistent load build-up under physiotherapeutic guidance to restore an optimal joint function in the further course.

Which Doctors and Clinics Are Specialized?

Trauma surgeons, orthopedics, and sports medicine specialists, or specialized joint clinics offer this microfracture procedure.

We will help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding microfracture surgery specialization and are awaiting your inquiry or treatment request.

Sources:

• germansportsmedicine.com
• aerztezeitung.de
• deutsche-kniegesellschaft.de
• Arthroskopie 2014, Springer Verlag