Our expert says:
Orthopaedic Specialist Forum
Microfracture is a procedure that falls under the category of mesenchymal cell proliferation. The idea is to stimulate marrow cells to form a type of scar cartilage to fill the defect in the chondral cartilage. It therefore produces a covering that never has the same function or structure of the original articular cartilage. In fact the closest we can get is cartilage transplant (autologous chondrocyte implantation) which even this does not restore the cartilage to absolutely normal.
There are unfortunately a number of variables which affect the outcome of the procedure. Firstly is the cause of the lesion. This may be traumatic, a fall or twist, or degenerative which is wear and tear and a precursor of arthritis. Obviously if this is arthritis it is not curable and is a progressive disease which while get worse with time. The technique and immediate rehabilitation( possibly the most important factor) can influence the outcome. Dr Steadman from the USA, who developed the technique, requires each patient to be on continuos motion for 6 hours a day!! In SA we request the patient to do 300 - 600 knee motions a day. Your age plays a role as often over 50 years the body does not have enough mesenchymal cells to make the new scar cartilage.
Local factors like size, thickness, site and chronicity also affect the result as does the mechanical alignment of your leg.
It would be best to see your surgeon again to find out why it is still causing pain. This will normally require another MRI to asses the lesion. A plan going forward can therefore be devised.
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