What Is It?
The body has many moving joints such as the shoulder, hip, and knee. These moving joints are called “synovial joints”. Synovial joints are able to move freely because of the cartilage covering across the two bones that make up the joint. This cartilage covering is referred to as “articular cartilage”. Injury to articular cartilage is called “chondromalacia”. The most significant type of chondromalacia occurs when the articular surface is damaged to the underlying bone.
When the articular surface cartilage of a joint is damaged down to bone, one may consider treatments to regenerate the injured joint surface. One such option is the microfracture procedure where the damaged joint surface is surgically stimulated to release local stem cells which fill-in the cartilage defect with a type of “clot”. Through post-operative rehabilitation, the goal is to encourage the clot of cells to transition into a cartilage-like substance called “fibrocartilage”. While not as durable as one’s original joint cartilage, it functions as a reasonable substitute.
Who Should Have It?
Microfracture is a technique typically applied in the setting of an isolated cartilage defect in a synovial joint. Important patient factors include type of joint, alignment of joint, smoking history, rehabilitation compliance, and “physiologic” age. The use of microfracture does not preclude the future option of other arthritis treatments such as joint resurfacing.
What Are Some of The Risks?
Microfracture is typically performed during arthroscopic surgery and involves similar surgical risks. A microfractured area may incompletely heal or not heal at all.