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Q:
I have had nagging knee pain for several years now. My doctor says it is due to articular cartilage damage. Is microfracture the correct procedure for me?
Answered by
Louis Meeks M.D.
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A:
Microfracture certainly is one of several procedures that are utilized for chondral defects in the knee. The choice of procedure is based on the surgeon’s experience and preference. It is like religion, it is based on how one has been taught and what works for them.
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Q:
I had a microfracture procedure a year ago. Initially, my symptoms subsided; however, now I am experiencing joint pain once again but have not undergone any traumatic experience to cause the pain. Do you know what is causing my symptoms?
Answered by
Louis Meeks M.D.
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A:
After a Microfracture procedure has healed internally, which can take up to six months, if pain recurs, one should have the knee re-evaluated by an experienced orthopedic surgeon.
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Q:
Are there any alternatives to the Microfracture procedure and, if there are, when should they be considered?
Answered by
Louis Meeks M.D.
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A:
There are currently several different techniques, or variations on the Microfracture technique for chondral lesions within the knee. Most of them give very similar outcomes.
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Q:
What type of rehabilitation is involved with the microfracture procedure? How long can I expect to be out of my normal activities?
Answered by
Louis Meeks M.D.
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A:
The type of rehabilitation involved with the Microfracture procedure varies from surgeon to surgeon. Dr. Richard Steadman, of the Steadman-Hawkins Clinic in Vail, Colorado, has popularized this procedure and he recommends using a continual passive motion exercise machine for a period of time, followed by partial weight-bearing with crutches for six to 12 weeks.
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Q:
Are there any alternatives to the Microfracture procedure and, if there are, when should they be considered?
Answered by
David Golden M.D.
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A:
There are procedures utilized to treat articular cartilage disorders. The main goal is to stimulate cells from the bone marrow to come to the joint surface and allow healing. The cartilage that grows is not identical to the native articular cartilage but attempts to serve the same functions. Abrasion techniques may also be used. There is no singular way to manage the joint surface. Sometimes a realignment surgery is coupled with treatment of the cartilage in order to decrease the strain on the affected area. Be sure to talk to your doctor about the various options.
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