Articular cartilage is a soft substance that lines the areas of bones, where they articulate with (touch) other bones, to form joints. Articular cartilage functions to provide smooth, pain-free motion and movement of the knee joint. This cartilage can become damaged when the joint is subjected to trauma or injury. Unlike some of the other structures within the knee, articular cartilage is not able to heal on its own. Over time, damage to articular cartilage can progress and lead to painful arthritis.
Orthopedic research has advanced in recent years in the treatment of articular cartilage. Researchers and surgeons have discovered new ways to address articular cartilage damage through procedures that help to regenerate cartilage growth and to help patients delay or prevent total knee replacement surgery.
Microfracture is a cartilage restoration procedure, which is used to treat focal cartilage defects (holes in cartilage all the way down to the bare bone) by promoting the growth of scar tissue (fibrocartilage) using bone marrow stem cells. Microfracture surgery is performed arthroscopically using two incisions the size of keyholes. Your physician will puncture an area of cartilage worn away to the exposed bone using a PowerPick drill. The creation of these “microfractures” allows bleeding from the subchondral layer of the bone, thus allowing the bone marrow elements and stem cells to flow into the joint. Marrow stimulation promotes new cartilage growth using knee stem cells. Microfracture results in fibrocartilage, which is not normal articular cartilage. Fibrocartilage (scar) covers the exposed bone, and results in decreased knee pain and improved function.
Following surgery, patients may be advised to avoid bearing weight by using crutches for 6 – 8 weeks. This is to protect the cells and provide an optimal environment for the new cartilage to form. Your physician will prescribe a thorough and progressive rehabilitation program that will consist of regaining range of motion and strength. Many patients are able to resume normal activities 2 -3 months after microfracture surgery.