Microfracture knee surgery is a recently developed surgical technique designed to repair damaged cartilage in the knee. Normally the ends of the bones of the knee joint – the tibia and femur – are lined with a continuous, smooth protective coating of hyaline cartilage. The cartilage acts to cushion against the force generated by walking and running.
Repeated trauma from intense athletic activity causes wear and tear of cartilage, resulting in small defects in the normally smooth surface. These cartilage defects cause pain. Until the recent development of microfracture surgery these cartilage defects were untreatable.
Description of Microfracture Surgery
Microfracture surgery is performed using arthroscopic technique. That is, the surgery is performed using a specialized knee scope through a small incision in the skin. The arthroscope is inserted and small holes are drilled in the affected portion of the knee joint cartilage. The holes promote bleeding of the surface, allowing a blood clot to form on the cartilagenous surface. The bone marrow cells contained in the blood clot promote the formation of new cartilage in the surgical area.
The type of cartilage formed after surgery is a different type then the original knee cartilage. Fibrocartilage will form after surgery, rather than the original hyaline type of cartilage. The new smooth cartilage surface will eliminate the pain associated with catilage defects, by covering them. However, fibrocartilage is less sturdy than native hyaline cartilage, and may break down after a few years.
Reasons for Microfracture Surgery
Microfracture surgery is becoming increasingly common in athletes with chronic knee pain due to cartilage damage. Several high profile professional athletes have undergone the procedure successfully. Athletes may undergo surgery for the following reasons:
- To repair traumatic cartilage damage.
- To repair degenerative cartilage damage.
- To treat early arthritis of the knee.
- To treat cartilage damage of the patella.
Rehabilitation after Microfracture Sugery
Microfracture surgery has a high rate of success, in terms of improving pain and function of the knee. Microfracture surgery patients are generally not allow to bear weight on the affected knee for 6 to 8 weeks after the procedure. During this time, patients are required to use crutches to get around. Physical therapy, consisting of passive range of motion exercises, may begin almost immediately after surgery. After the initial non-weight bearing recovery period is over, slow weight bearing is introduced followed by more rigorous exercises. Return to normal athletic activity may take anywhere from 4 to 8 months.
Risks of Microfracture Surgery
Microfracture surgery, like any invasive procedure, can result in post operative complications. Risks common to all surgeries, including microfracture surgery, include anesthesia risk, bleeding, and infection. Risks unique to microfracture surgery include breakdown of the newly formed fibrocartilage, and long term post operative stiffness of the knee joint.
 |
