This case series reports functional outcomes of arthroscopic microfracture for isolated traumatic full-thickness chondral defects in 72 patients (75 knees) aged ≤45 years. All patients had no concurrent meniscal or ligamentous pathology, isolating the effect of microfracture on cartilage injury alone. Follow-up averaged 11.3 years (range 7–17), with 95% of knees available at final evaluation.
Maximum improvement after microfracture takes 2–3 years — this is the most important counseling point before surgery. Patients often have ongoing symptoms in the early postoperative period and need reassurance that this is expected, not failure.
When selecting candidates, age under 35 with an isolated traumatic chondral defect and no meniscal or ligamentous pathology defines the ideal patient. This group gains the most and sustains it longest. For patients aged 35–45, improvement is still significant and durable (+26 Lysholm points at 11 years), but temper expectations modestly compared to younger patients.
The zero-complication rate and 2.7% failure rate make microfracture a defensible first arthroscopic step before committing to ACI, mosaicplasty, or allograft. Procedures the authors note require additional surgeries and have less long-term comparative data.
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This case series reports functional outcomes of arthroscopic microfracture for isolated traumatic full-thickness chondral defects in 72 patients (75 knees) aged ≤45 years. All patients had no concurrent meniscal or ligamentous pathology, isolating the effect of microfracture on cartilage injury alone. Follow-up averaged 11.3 years (range 7–17), with 95% of knees available at final evaluation.
Maximum improvement after microfracture takes 2–3 years — this is the most important counseling point before surgery. Patients often have ongoing symptoms in the early postoperative period and need reassurance that this is expected, not failure.
When selecting candidates, age under 35 with an isolated traumatic chondral defect and no meniscal or ligamentous pathology defines the ideal patient. This group gains the most and sustains it longest. For patients aged 35–45, improvement is still significant and durable (+26 Lysholm points at 11 years), but temper expectations modestly compared to younger patients.
The zero-complication rate and 2.7% failure rate make microfracture a defensible first arthroscopic step before committing to ACI, mosaicplasty, or allograft. Procedures the authors note require additional surgeries and have less long-term comparative data.