Microfracture surgery is a treatment option that can help repair areas of damaged cartilage.If you have a small area of cartilage damage (not widespread arthritis), microfracture surgery may help stimulate new cartilage growth. While it is most commonly performed for knee joint problems, it can also be used effectively for problems in other joints in the body. It has also been used for treatment in other joints including the hip, ankle, shoulder, elbow, and other joints.
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What Is Microfracture Surgery?
A microfracture procedure creates small holes in the bone. The surface layer of bone, called the subchondral bone, is hard and lacks good blood flow. By penetrating this hard layer, a microfracture allows the deeper, more vascular bone to access the surface of the joint. This deeper bone has a rich blood supply, and the cells can get to the surface layer to stimulate cartilage growth.
How Does it Work?
Can Stem Cells Replace Lost Cartilage?
Who Is a Good Candidate for Microfracture Surgery?
There are some factors that can determine whether you are likely to experience a good outcome from having microfracture surgery.
Good CandidateLimited areas of cartilage damageHas pain and swelling due to cartilage damagePhysically active but cannot participate in sport because of the damageNot a Good CandidateHas widespread arthritisHas joint misalignment or instabilityIs inactiveHas inflammatory arthritis (such asrheumatoid arthritis)Is unwilling to participate in rehabilitation
Good CandidateLimited areas of cartilage damageHas pain and swelling due to cartilage damagePhysically active but cannot participate in sport because of the damage
Limited areas of cartilage damage
Has pain and swelling due to cartilage damage
Physically active but cannot participate in sport because of the damage
Not a Good CandidateHas widespread arthritisHas joint misalignment or instabilityIs inactiveHas inflammatory arthritis (such asrheumatoid arthritis)Is unwilling to participate in rehabilitation
Has widespread arthritis
Has joint misalignment or instability
Is inactive
Has inflammatory arthritis (such asrheumatoid arthritis)
Is unwilling to participate in rehabilitation
Alternatives
Microfracture surgery is generally considered the first-line treatment for cartilage damage in the knee joint. Before deciding to have microfracture surgery, you and your surgeon will discuss othertreatments for cartilage defects, such ascartilage transferand cartilage implantation.
The success of these surgical options has been shown to be no better than microfracture, while the risks and costs of microfracture are dramatically less.Some of these other surgical options are generally done for athletes who have failed to improve after microfracture surgery.
Knee Cartilage Replacement
Procedure
During the procedure:
Recovery and Rehabilitation
Most people need to use crutches after surgery. Often, a knee brace will be recommended. And in some situations, a motion machine to bend the knee may be used.
Microfracture surgery of the knee is a safe procedure with minimal risks. Persistent pain despite surgical intervention is the main concern. Other more severe complications, such as infection, blood clots, and swelling, are uncommon.
Outcomes and Limitations
Microfracture can be an excellent procedure, providing substantial pain relief. One of the concerns with microfracture is that it does not stimulate the growth of normal joint cartilage.
There are many types of cartilage, and one of these (hyaline cartilage) is normally found on the joint surface. Microfracture stimulates the growth of another type of cartilage commonly found in scar tissue (called fibrocartilage).
Interesting Facts About Cartilage
Because microfracture stimulates a less resilient form of cartilage, the long-term results are often unsatisfactory. Over time, people who undergo this procedure may end up experiencing significant progression of arthritis.
A Word From Verywell
Microfracture surgery is popular because it is safe, relatively easy to perform, and comparatively inexpensive to other cartilage stimulation surgical procedures.In general, people who undergo microfracture surgery do reasonably well in the short to mid-term.
There are questions, however, about the durability of microfracture repair, and most surgeons agree that the cartilage that heals within a microfracture defect is not nearly as durable as normal cartilage.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Steadman JR, Rodkey WG, Briggs KK.Microfracture: its history and experience of the developing surgeon.Cartilage. 2010;1(2):78-86. doi:10.1177/1947603510365533Kraeutler MJ, Belk JW, Purcell JM, McCarty EC.Microfracture versus autologous chondrocyte implantation for articular cartilage lesions in the knee: a systematic review of 5-year outcomes.Am J Sports Med. 2018;46(4):995-999. doi:10.1177/0363546517701912Strauss EJ, Barker JU, Kercher JS, Cole BJ, Mithoefer K.Augmentation strategies following the microfracture technique for repair of focal chondral defects.Cartilage. 2010;1(2):145-152. doi:10.1177/1947603510366718Niemeyer P, Schubert T, Grebe M, Hoburg A.Treatment costs of matrix-associated autologous chondrocyte implantation compared with microfracture: Results of a matched-pair claims data analysis on the treatment of cartilage knee defects in Germany.Orthop J Sports Med. 2019;7(12):2325967119886583. doi:10.1177/2325967119886583Additional ReadingNiemeyer P, Schubert T, Grebe M, Hoburg A.Matrix-associated chondrocyte implantation is associated with fewer reoperations than microfracture: Results of a population-representative, matched-pair claims data analysis for cartilage defects of the knee.Orthop J Sports Med. 2019;7(10):2325967119877847. doi:10.1177/2325967119877847Tuan RS, Chen AF, Klatt BA.Cartilage regeneration.J Am Acad Orthop Surg. 2013;21(5):303–311. doi:10.5435/JAAOS-21-05-303
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Steadman JR, Rodkey WG, Briggs KK.Microfracture: its history and experience of the developing surgeon.Cartilage. 2010;1(2):78-86. doi:10.1177/1947603510365533Kraeutler MJ, Belk JW, Purcell JM, McCarty EC.Microfracture versus autologous chondrocyte implantation for articular cartilage lesions in the knee: a systematic review of 5-year outcomes.Am J Sports Med. 2018;46(4):995-999. doi:10.1177/0363546517701912Strauss EJ, Barker JU, Kercher JS, Cole BJ, Mithoefer K.Augmentation strategies following the microfracture technique for repair of focal chondral defects.Cartilage. 2010;1(2):145-152. doi:10.1177/1947603510366718Niemeyer P, Schubert T, Grebe M, Hoburg A.Treatment costs of matrix-associated autologous chondrocyte implantation compared with microfracture: Results of a matched-pair claims data analysis on the treatment of cartilage knee defects in Germany.Orthop J Sports Med. 2019;7(12):2325967119886583. doi:10.1177/2325967119886583Additional ReadingNiemeyer P, Schubert T, Grebe M, Hoburg A.Matrix-associated chondrocyte implantation is associated with fewer reoperations than microfracture: Results of a population-representative, matched-pair claims data analysis for cartilage defects of the knee.Orthop J Sports Med. 2019;7(10):2325967119877847. doi:10.1177/2325967119877847Tuan RS, Chen AF, Klatt BA.Cartilage regeneration.J Am Acad Orthop Surg. 2013;21(5):303–311. doi:10.5435/JAAOS-21-05-303
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Steadman JR, Rodkey WG, Briggs KK.Microfracture: its history and experience of the developing surgeon.Cartilage. 2010;1(2):78-86. doi:10.1177/1947603510365533Kraeutler MJ, Belk JW, Purcell JM, McCarty EC.Microfracture versus autologous chondrocyte implantation for articular cartilage lesions in the knee: a systematic review of 5-year outcomes.Am J Sports Med. 2018;46(4):995-999. doi:10.1177/0363546517701912Strauss EJ, Barker JU, Kercher JS, Cole BJ, Mithoefer K.Augmentation strategies following the microfracture technique for repair of focal chondral defects.Cartilage. 2010;1(2):145-152. doi:10.1177/1947603510366718Niemeyer P, Schubert T, Grebe M, Hoburg A.Treatment costs of matrix-associated autologous chondrocyte implantation compared with microfracture: Results of a matched-pair claims data analysis on the treatment of cartilage knee defects in Germany.Orthop J Sports Med. 2019;7(12):2325967119886583. doi:10.1177/2325967119886583
Steadman JR, Rodkey WG, Briggs KK.Microfracture: its history and experience of the developing surgeon.Cartilage. 2010;1(2):78-86. doi:10.1177/1947603510365533
Kraeutler MJ, Belk JW, Purcell JM, McCarty EC.Microfracture versus autologous chondrocyte implantation for articular cartilage lesions in the knee: a systematic review of 5-year outcomes.Am J Sports Med. 2018;46(4):995-999. doi:10.1177/0363546517701912
Strauss EJ, Barker JU, Kercher JS, Cole BJ, Mithoefer K.Augmentation strategies following the microfracture technique for repair of focal chondral defects.Cartilage. 2010;1(2):145-152. doi:10.1177/1947603510366718
Niemeyer P, Schubert T, Grebe M, Hoburg A.Treatment costs of matrix-associated autologous chondrocyte implantation compared with microfracture: Results of a matched-pair claims data analysis on the treatment of cartilage knee defects in Germany.Orthop J Sports Med. 2019;7(12):2325967119886583. doi:10.1177/2325967119886583
Niemeyer P, Schubert T, Grebe M, Hoburg A.Matrix-associated chondrocyte implantation is associated with fewer reoperations than microfracture: Results of a population-representative, matched-pair claims data analysis for cartilage defects of the knee.Orthop J Sports Med. 2019;7(10):2325967119877847. doi:10.1177/2325967119877847Tuan RS, Chen AF, Klatt BA.Cartilage regeneration.J Am Acad Orthop Surg. 2013;21(5):303–311. doi:10.5435/JAAOS-21-05-303
Niemeyer P, Schubert T, Grebe M, Hoburg A.Matrix-associated chondrocyte implantation is associated with fewer reoperations than microfracture: Results of a population-representative, matched-pair claims data analysis for cartilage defects of the knee.Orthop J Sports Med. 2019;7(10):2325967119877847. doi:10.1177/2325967119877847
Tuan RS, Chen AF, Klatt BA.Cartilage regeneration.J Am Acad Orthop Surg. 2013;21(5):303–311. doi:10.5435/JAAOS-21-05-303
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