Mithoefer, J Bone Joint Surg Am 2005 - The Microfracture Technique for the Treatment of Articular Cartilage Lesions in the Knee. A Prospective Cohort Study

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The Microfracture Technique for the Treatment of Articular Cartilage Lesions in the Knee. A Prospective Cohort Study

Mithoefer, Marx, et al.·J Bone Joint Surg Am·2005·591 citations·Prospective cohort

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Background

Microfracture is a frequently used technique for the repair of articular cartilage lesions of the knee. Despite the popularity of the technique, prospective information about the clinical results after microfracture is still limited. The purpose of our study was to identify the factors that affect the clinical outcome from this cartilage repair technique.

Methods

48 symptomatic patients with isolated full-thickness articular cartilage defects of the femur in a stable knee were treated with the microfracture technique. Prospective evaluation of patient outcome was performed for a minimum follow-up of 24 months with a combination of validated outcome scores, subjective clinical rating, and cartilage-sensitive magnetic resonance imaging.

Results

At the time of the latest follow-up, knee function was rated good to excellent for 32 patients (67%), fair for 12 patients (25%), and poor for 4 (8%).
Significant increases in the activities of daily living scores, International Knee Documentation Committee scores, and the physical component score of the Short Form-36 were demonstrated after microfracture (p < 0.05).
A lower body-mass index correlated with higher scores for the activities of daily living and SF-36 physical component, with the worst results for patients with a body-mass index of >30 kg/m2.
Significant improvement in the activities of daily living score was more frequent with a preoperative duration of symptoms of less than 12 months (p < 0.05).
Magnetic resonance imaging in 24 knees demonstrated good repair-tissue fill in the defect in 13 patients (54%), moderate fill in 7 (29%), and poor fill in 4 patients (17%).
The fill grade correlated with the knee function scores.
All knees with good fill demonstrated improved knee function, whereas poor fill grade was associated with limited improvement and decreasing functional scores after 24 months.

Conclusions

Microfracture repair of articular cartilage lesions in the knee results in significant functional improvement at a minimum follow-up of two years. The best short-term results are observed with good fill grade, low body-mass index, and a short duration of preoperative symptoms. A high body-mass index adversely affects short-term outcome, and a poor fill grade is associated with limited short-term durability.

Level of evidence: Therapeutic Level IV. Copyright remains with the authors and publisher.

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The Microfracture Technique for the Treatment of Articular Cartilage Lesions in the Knee. A Prospective Cohort Study

Mithoefer, Marx, et al.·J Bone Joint Surg Am·2005·591 citations·Prospective cohort

|

Background

Microfracture is a frequently used technique for the repair of articular cartilage lesions of the knee. Despite the popularity of the technique, prospective information about the clinical results after microfracture is still limited. The purpose of our study was to identify the factors that affect the clinical outcome from this cartilage repair technique.

Methods

48 symptomatic patients with isolated full-thickness articular cartilage defects of the femur in a stable knee were treated with the microfracture technique. Prospective evaluation of patient outcome was performed for a minimum follow-up of 24 months with a combination of validated outcome scores, subjective clinical rating, and cartilage-sensitive magnetic resonance imaging.

Results

At the time of the latest follow-up, knee function was rated good to excellent for 32 patients (67%), fair for 12 patients (25%), and poor for 4 (8%).
Significant increases in the activities of daily living scores, International Knee Documentation Committee scores, and the physical component score of the Short Form-36 were demonstrated after microfracture (p < 0.05).
A lower body-mass index correlated with higher scores for the activities of daily living and SF-36 physical component, with the worst results for patients with a body-mass index of >30 kg/m2.
Significant improvement in the activities of daily living score was more frequent with a preoperative duration of symptoms of less than 12 months (p < 0.05).
Magnetic resonance imaging in 24 knees demonstrated good repair-tissue fill in the defect in 13 patients (54%), moderate fill in 7 (29%), and poor fill in 4 patients (17%).
The fill grade correlated with the knee function scores.
All knees with good fill demonstrated improved knee function, whereas poor fill grade was associated with limited improvement and decreasing functional scores after 24 months.

Conclusions

Microfracture repair of articular cartilage lesions in the knee results in significant functional improvement at a minimum follow-up of two years. The best short-term results are observed with good fill grade, low body-mass index, and a short duration of preoperative symptoms. A high body-mass index adversely affects short-term outcome, and a poor fill grade is associated with limited short-term durability.

Level of evidence: Therapeutic Level IV. Copyright remains with the authors and publisher.

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