Technique paper by Steadman — microfracture's developer — tracing the procedure's evolution from the early 1980s through animal studies and clinical outcomes series. Covers surgical rationale, operative steps for acute and degenerative lesions, rehabilitation protocols, and factors that predict success or failure.
When you perform microfracture, three variables most influence outcome: ensure the weightbearing line falls within 25% of neutral (correct malalignment first), confirm the cartilage rim surrounding the defect is tall enough to contain the marrow clot, and verify the patient can commit to 6–8 weeks of protected weightbearing with CPM — without rehabilitation compliance, published results do not apply.
In degenerative or chronic lesions, debride sclerotic bone to punctate bleeding and meticulously remove the calcified cartilage layer before making microfracture holes, as retention of that layer impedes repair tissue attachment.
Technique paper by Steadman — microfracture's developer — tracing the procedure's evolution from the early 1980s through animal studies and clinical outcomes series. Covers surgical rationale, operative steps for acute and degenerative lesions, rehabilitation protocols, and factors that predict success or failure.
When you perform microfracture, three variables most influence outcome: ensure the weightbearing line falls within 25% of neutral (correct malalignment first), confirm the cartilage rim surrounding the defect is tall enough to contain the marrow clot, and verify the patient can commit to 6–8 weeks of protected weightbearing with CPM — without rehabilitation compliance, published results do not apply.
In degenerative or chronic lesions, debride sclerotic bone to punctate bleeding and meticulously remove the calcified cartilage layer before making microfracture holes, as retention of that layer impedes repair tissue attachment.