What is a microfracture procedure?

Microfracture is a surgical operation that is used to try and regrow cartilage in an area that has been damaged.

Microfracture is normally performed arthroscopically (through keyhole surgery). The first step is to identify the area of damage and assess its size, position and if the underlying bone is damaged as well. The loose or damaged cartilage is then cleared away leaving a bare bone surface.

Next, small holes are drilled or punched into the bone to create bleeding. The idea is for a blood clot to form and fill the area where the cartilage defect has occurred. The blood clot will then be gradually filled with cartilage producing cells that will replace the blood clot with cartilage. Normally this new cartilage is not as good as the original cartilage but will be better than having no cartilage there.

What is the rehabilitation after a microfracture procedure?

This is a difficult question and depends on the size and position of the area that is treated. In general principle we want the blood clot to be left undisturbed and for the cartilage cells not to be stressed by being overloaded while there is healing taking place.

Sometimes the knee is placed in a splint for 2-3 days after surgery to keep it straight. You may be asked to use crutches to keep your weight off the knee for up to 6 weeks. You will not be running for at least 3-6 months following surgery.

What is Cargel?

Cargel is a biologic agent that is added to a small amount of blood taken from thee patient and is injected onto the area of microfracture. In some studies, it has been shown to increase the quality and quantity of cartilage regrowth compared to microfracture alone.

  • Cartilage injury identified

    Step 1:
    Cartilage injury identified

  • Damaged cartilage cleared leaving bare bone

    Step 2: damaged cartilage cleared
    leaving bare bone

  • Holes drilled in bone

    Holes drilled in bone

  • Bleeding occurs from holes

    Step 4:
    Bleeding occurs from holes

  • Cargel is layered

    Step 5:
    Cargel is layered onto area

  • cartilage regrowth

    Step 6:
    cartilage regrowth 1 year later

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