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Knee Micro-Fracture Surgery

Dr A H M Rezaul Haque

Nasima  Akter,  a  40 year old lady complained of pain in the left knee for six months due to a fall.  She consulted with an orthopaedic doctor & did all kinds of relevant investigations but did not get any relief. We examined her & saw her reports but could not correlate clinical findings with the investigation. So, we advised her for arthroscopy and during arthroscopy found cartilage injury and exposed subchondral  bone.  Her ligaments and meniscus were intact. Hence, we performed micro-fracture. After two months she got relief from pain.

Micro-fracture surgery is an articular cartilage repair surgical technique that works by creating tiny fractures in the underlying bone. This causes new cartilage to develop from a so-called super clot. Micro-fracture surgery was developed in early 1990s by Dr Richard Steadman and has gained popularity in sports in recent years.

Knee micro-fracture surgery is a common procedure used to repair damaged knee cartilage. Cartilage helps cushion and cover the area where the bones meet at the joints. When cartilage damage occurs, joints no longer have smoothness between the bones. Cartilage damage is like a pothole on the road. In cartilage repair we are filling in the pothole so it does not get larger.

Micro-fracture therapies try to harness the body’s healing power to repair damaged cartilage that must heal & mature into an effective repair tissue for the procedure to work.

Cartilage restoration bridges the gap between symptom relief & joint replacement surgery.

Indication

•     Repair of injured or damaged cartilage in the joint

•     Prevention or slowdown of arthritis development

•     Osteochondritis dissecans

Drawback of Micro-fracture

•     The new cartilage (fibrocartilage) made by micro-fracture is not as strong as the body’s original hyaline cartilage

Procedure

Micro-fracture surgery is performed through arthroscopy. It takes about 30-60 minutes and can be done as an outpatient basis.

Most people do well after this surgery though recovery time can be slow. Many people can go back to sports or other intense activities in about 4-6 months. People under the age of 40 with a recent cartilage injury often get the best result. People who  are not over weight also have better results.

 

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