Cartilage Injury of the Knee: Current Controversies (2021 Annual Meeting)-Cartilage Injury of the Knee: Current Controversies in 2021-Frank

Video Transcription

Video Summary

Dr. Frank discusses advances in microfracture surgery for cartilage defects, emphasizing careful patient selection and managing expectations. Cartilage lesions are common in knee arthroscopy, yet not all require treatment. Microfracture, a marrow stimulation technique producing fibrocartilage, is best suited for small, contained lesions without symptomatic subchondral bone involvement. Proper lesion preparation and surgical technique, including micro-drilling over traditional awling, are critical for success. Outcomes show initial improvement at 6-12 months but often decline after two years. Debridement remains a common, less invasive option, especially for in-season athletes. Trends show microfracture use decreasing as more durable procedures like osteochondral transplant rise. New “microfracture plus” methods combine microfracture with scaffolds and biologics to enhance cartilage repair, supported by recent positive clinical and laboratory data. Rehab protocols are rigorous, similar to complex cartilage procedures. The overall message highlights viewing the joint holistically and integrating biologics to improve microfracture durability while acknowledging ongoing debate and individualized treatment.

Asset Caption

Dr. Rachel Frank

Keywords

microfracture surgery

cartilage defects

knee arthroscopy

fibrocartilage

osteochondral transplant

biologics