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What is Patella Microfracture Surgery?

Patella microfracture surgery is an arthroscopic surgical procedure performed to repair damaged articular cartilage of the patella by making small holes in the bone to promote healing.

Key statistics about Patella Microfracture Surgery

  • Approximately 12% of the population suffer from cartilage defects in the knee[1]
  • 60% of patients who undergo knee arthroscopy are discovered to have cartilage defects[2]
  • 95% of patients who undergo microfracture surgery experience improved knee function and decreased symptoms after the procedure[3]

Knee Anatomy

The knee joint is formed by three bones: the femur (thigh bone), the tibia (shin bone), and the patella (kneecap). As the knee bends and straightens, the patella moves back and forth within a groove on the femur called the trochlea.

Two 3D renderings of the knee with colorized regions highlighting the anatomy of the knee

Articular cartilage covers the ends of the femur and tibia, the trochlea, and the underside of the patella, helping with shock absorption and allowing the bones to glide smoothly against one another.

3D rendering of the knee clearly calling out the trochlea - the region of the knee just behind the knee cap

Why is Patella Microfracture Surgery performed?

Articular cartilage damage can expose the underlying bone, causing pain and affecting joint function as the knee moves. Microfracture surgery is performed to repair these articular cartilage injuries within the knee joint (Knee Microfracture Surgery) or behind the patella.

The goal of patella microfracture surgery is to address cartilage injuries to the patella and trochlea in order to alleviate pain and restore a smooth joint surface. This procedure can also prevent the progression of cartilage damage and delay knee replacement.

Who needs Patella Microfracture Surgery?

Damage to patellar articular cartilage typically is caused by overuse or injury.

Ideal candidates for the procedure have smaller regions of cartilage damage (no widespread osteoarthritis or rheumatoid arthritis), have normal knee alignment and stability, and are relatively young, active, and willing to commit to physical therapy.

How is Patella Microfracture Surgery performed?

  • The surgeon will make small incisions around the knee joint and the arthroscope will be inserted into one of the incisions.
  • Saline solution is pumped into the joint to expand it and improve visualization.
  • Images from the arthroscope are sent to a video monitor where the surgeon can see inside the joint.
  • The damaged cartilage on the underside of the patella is removed.
  • A drill is used to make small holes in the exposed bone of the patella.
  • Finally, the saline solution is drained, instruments are removed, and the incisions are closed using sutures.

What are the risks of Microfracture Surgery?

It is uncommon to experience complications from microfracture surgery but potential risks may include:

  • Infection
  • Blood clots
  • Nerve or blood vessel damage
  • Knee stiffness

How long does it take to recover from Microfracture Surgery?

  • 24 hours after surgery
    Most patients are able to return home the same day as their procedure. A physical therapy routine will be established by the surgeon and physical therapist, and crutches will be provided. Pain medication may be prescribed.
  • 2 weeks after surgery
    Any non-dissolvable sutures are removed and bruising and swelling begin to subside.
  • 4-7 months after surgery
    Most patients are able to resume daily activities, including walking without assistance.
  • 9-12 months after surgery
    Most patients are fully recovered from microfracture surgery.

What are the results of Microfracture Surgery?

Microfracture surgery is a safe and effective procedure performed to treat smaller areas of articular cartilage damage in the knee. 95% of patients who undergo microfracture surgery experience improved knee function and a decrease in symptoms after the procedure[3].

Sources
1
Song, S.J. & Park, C.H. (2019). Microfracture for cartilage repair in the knee: current concepts and limitations of systematic reviews. Annals of Translational Medicine. 7(3), S108. https://doi.org/10.21037/atm.2019.05.11
2
Smoak, J.B., Kluczynski, M.A., Bisson., L.J., & Marzo, J.M. (2019). Systematic Review of Patient Outcomes and Associated Predictors After Microfracture in the Patellofemoral Joint. JAAOS: Global Research and Reviews. 3(11), e19.00151. https://doi.org/10.5435/JAAOSGlobal-D-19-00151
3
Steadman, J.R., Briggs, K.K., Rodrigo, J.J., Kocher, M.S., Gill, T.J., & Rodkey, W. G. (2003). Outcomes of microfracture for traumatic chondral defects of the knee: Average 11-year follow-up. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 19(5), 477-484. https://doi.org/10.1053/jars.2003.50112
Last edited on October 27th, 2023 5:34 pm