APEX Knee Navigating Pearls and Pitfalls-Smaller Lesion Debate: MFX vs Autograft Transfer 2

Smaller Lesion Debate: MFX vs Autograft Transfer 2

Video Transcription

Video Summary

Dr. Clay Nully discusses treatment options for small cartilage lesions: microfracture (marrow stimulation) versus autologous osteochondral transfer. Cartilage injuries rarely heal spontaneously due to poor blood supply. Microfracture is a simpler, single-stage, arthroscopic technique suitable for low-demand patients with small lesions but often results in fibrocartilage and has declining outcomes over time, especially in athletes. Proper technique minimizing subchondral bone damage is crucial. Autograft transfer involves transplanting mature cartilage-bone plugs, ideal for lesions <1.5-2 cm², offering better long-term outcomes and quicker return to sport, though limited by donor availability and technical difficulty. Overall, autograft transfer is preferred for small, focal full-thickness defects.

Asset Caption

Dr. Clayton W. Nuelle

Keywords

microfracture

autologous osteochondral transfer

cartilage lesions

fibrocartilage

donor site morbidity