Chondral Injury of the Knee: Current Controversies in 2019 (AANA19)-Should We Still Consider Microfracture A Viable Option In 2019

Should We Still Consider Microfracture A Viable Option In 2019_-Dr. Rachel M. Frank, M.D.

Video Transcription

Video Summary

The panel discussion explores the viability of microfracture as a treatment for cartilage lesions in 2019. Microfracture is praised for being minimally invasive, low-cost, and easy to perform arthroscopically for small, contained lesions. However, it produces fibrocartilage rather than durable hyaline cartilage, which raises concerns about long-term efficacy and durability, especially beyond two years. Return-to-play rates vary, often lower compared to other cartilage restoration techniques like osteochondral autografts, which show better outcomes and faster recovery. The procedure also demands patient compliance due to lengthy rehab protocols and can potentially burn bridges for future surgeries if not appropriately indicated. Augmented microfracture (microfracture plus biologics or scaffolds) shows promise but requires further evidence. Experts emphasize careful patient selection, technique precision, and considering alternative treatments for larger or complex lesions. Overall, microfracture remains an option for small defects but may be less optimal given newer, more durable cartilage repair strategies.

Asset Caption

Instructional Course Lecture: Chondral Injury of the Knee: Current Controversies in 2019

Keywords

microfracture

cartilage lesions

fibrocartilage

return-to-play rates

augmented microfracture