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Microfracture Can Benefit Small Articular Cartilage Lesions

Treatment shown to work in athletes, studies show.

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By: Michael Barbella

Managing Editor

Researchers contend that patients with small articular cartilage defects may benefit from microfracture.

“There are reams of basic science supporting utility of stem cells, and marrow cells do in fact form cartilage. It is all about the technique,” John D. Kelly IV, M.D., said.

Researchers involved in previously published studies have shown that microfracture works in athletes, with average follow-up periods as long as 11 years, he added. However, these studies show patients with smaller lesions of 2 cm or less fare better.

Shear stress needs to be minimized and there are more reliable clots. Kelly advised orthopedic surgeons to remove the calcified layer to increase adherence clots. Also, patients should be non-weight bearing to avoid subchondral stiffness, he said.

“Microfracture is a stem cell-generating procedure to help many people. Smaller, well-shoulder lesions reliably do well. Non-weightbearing is the key to avoid subchondral stiffness. When I have controversy, I go with the least invasive option,” Kelly said.

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