The Microfracture Technique: Pearls and Pitfalls

Devin P. Leland, Christopher D. Bernard, Aaron J. Krych

Volume 4 | Issue 1 | Jan – April 2019 | Page 4- 14

Author: Devin P. Leland[1], Christopher D. Bernard[1], Aaron J. Krych[1*]

From the Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.

Address of Correspondence
Dr. Aaron J. Krych, MD
Mayo Clinic, 200 First Street SW, Rochester, MN 55905
Email: Krych.Aaron@Mayo.edu

Abstract

Preservation of articular cartilage is essential for appropriate health and function of the knee. Chondral lesions have therefore been identified as a common cause of knee pain and morbidity. For many years, the microfracture technique has offered a simple and minimally invasive procedure for the treatment of isolated articular cartilage lesions. Identifying patients who are appropriate for microfracture is difficult and requires careful selection. Younger patients (<35 years of age) with smaller lesions (<2 cm2) who are non-obese have demonstrated the greatest improvement following microfracture, especially in the short-term (<24 months). However, long-term outcomes are less promising and advanced cartilage restoration techniques such as osteochondral grafting or chondrocyte implantation have been developed. As a result, the focus of current research is centered on comparing microfracture to these more novel techniques to determine which procedure(s) offer superior long-term results. Ultimately, the orthopedist’s goal has not changed since originally implementing the microfracture procedure: to provide patients with full-thickness isolated chondral defects the best available treatment for long-term preservation of knee function and biomechanics.

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