What is Microfracture Surgery?
Recently, I have been treating an increasing number of patients who have had microfracture surgery, either in conjunction with another procedure, or by itself. Due to the fact that ACL reconstructions, meniscal repairs and other similar knee surgeries have been around for many years, there seem to be fewer questions surrounding them than microfracture surgery.
Microfracture surgery is done to patients with cartilage defects of the knee, which are a common cause of knee pain. Cartilage defects may be either in the knee joint itself or underneath the kneecap. The microfracture procedure was developed about 20 years ago, but has become more popular in the past 5 years, as the success rate has continued to improve. Now, about 75-80% of patients who undergo microfracture surgery report a decrease in symptoms after surgery.
This procedure can be done to treat a variety of conditions of the knee, such as DJD (degenerative joint disease) or lesions in the knee joint and/or underneath the kneecap. Microfracture surgery is most successful in young, athletic patients, and has been successful in many professional athletes, including Jason Kidd, Tracy McGrady, Amar’e Stoudamire, Darren Sharper and Reggie Bush.
The procedure itself is done arthroscopically. Small holes or “microfractures” are made in the affected area of cartilage. The theory behind making these small holes in the cartilage is that the body will respond by forming a clot over the operative area. Eventually, the clot will mature to form a layer of durable tissue over the damaged cartilage. Due to the nature of this healing process, it may take anywhere from 2-6 months before a patient feels relief of his or her symptoms. Symptoms may continue to decrease for up to 2 years after surgery.
After surgery, the protocol will vary, depending on the surgeon as well as a few other factors, including the location of the cartilage defect, size of the cartilage defect, and whether or not any additional surgery was done concurrently.
During the time immediately following surgery, weight bearing will be more limited when the surgical area is either at the end of the femur or tibia (thigh bone or shin bone). On the other hand, knee motion will be more limited when the surgical area is underneath the kneecap, because increased bending causes compression on the surgical area. Once it is deemed “safe” by your surgeon, motion and weight bearing on the surgical area will help to stimulate healing and re-growth at the surgical site, which in turn will help to fill in the “microfractures.”
As far as long-term recovery goes, many patients are able to return to running and other high impact activities between 4-6 months after surgery, again depending on the surgeon as well as the specifics regarding the procedure.
Hopefully, this has been helpful for those of you considering the surgery, as well as for those who have already had it and never quite understood exactly what was done!!
Please contact Erica with any questions/comments (Erica@jointventurespt.com).
