Microfracture is a surgical technique used for cartilage repair in joints. It is typically performed arthroscopically and is most commonly used for smaller cartilage defects, usually less than 2 to 4 cm in size. The procedure aims to stimulate the formation of new cartilage by creating small holes in the underlying bone.
Here is an overview of the microfracture procedure for cartilage repair:
1. Anesthesia:
The procedure is usually performed under general anesthesia or regional anesthesia, depending on the patient’s condition and surgeon’s preference. This ensures that the patient is comfortable and pain-free during the surgery.
2. Arthroscopy and Evaluation:
Small incisions are made around the joint, and an arthroscope is inserted through one of the incisions. The arthroscope allows the surgeon to visualize the joint’s interior and assess the cartilage damage. The extent and location of the cartilage defect are evaluated.
3. Preparation:
The damaged cartilage is gently debrided and smoothed to create a stable base for the microfracture procedure. This involves removing any loose or damaged cartilage fragments and tidying up the edges of the defect.
4. Microfracture:
Using a specialized tool called an awl or a pick, the surgeon creates multiple small holes, or “microfractures,” in the underlying bone. These holes penetrate the subchondral bone, which is the layer of bone just below the damaged cartilage.
5. Blood Clot Formation:
The microfractures create channels for blood and bone marrow cells to seep out from the bone and form a blood clot within the cartilage defect. The clot contains cells that have the potential to develop into new cartilage tissue.
6. Rehabilitation and Recovery:
Following the procedure, the patient is typically monitored in a recovery area before being discharged. The surgeon may provide specific instructions regarding weight-bearing, activity limitations, pain management, and rehabilitation. Weight-bearing restrictions are typically imposed to protect the healing cartilage. Physical therapy and rehabilitation exercises are initiated to gradually restore range of motion, strength, and function to the joint. The rehabilitation process is usually tailored to the individual patient and may involve a period of protected weight-bearing followed by progressive strengthening exercises.
Over time, the blood clot within the cartilage defect matures and transforms into a fibrocartilaginous tissue. This new tissue is not identical to the original hyaline cartilage, but it can help fill in the defect and provide some pain relief and improved function.
It’s important to note that microfracture is most effective for smaller cartilage defects and may not be suitable for larger or more severe cartilage damage. The success of the procedure depends on various factors, including the size and location of the defect, patient age, overall joint health, and adherence to postoperative rehabilitation protocols.
It’s recommended to consult with an orthopedic surgeon or a specialist in cartilage repair who can evaluate your specific condition, discuss the available treatment options, and determine whether microfracture is the most appropriate approach for your cartilage repair based on your individual needs. . At Alabama Bone and Joint Clinic our specialists are able to guide you through your treatment options. Call today to schedule an appointment with one of our experts in orthopedic care.
