Microfracture can be good option for patients with small articular cartilage lesions

WAILEA, Hawaii — Patients with small articular cartilage defects may benefit from microfracture, a presenter at Orthopedics Today Hawaii 2014 said, here.

“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, MD, said.

John D. Kelly IV

He said that researchers involved in previously published studies have shown that microfracture works in athletes, with average follow-up periods as long as 11 years. However, these studies indicate that patients with smaller lesions of 2 cm or less do better.

Patients with smaller lesions tend to do well, Kelly said.

Shear stress needs to be minimized and there are more reliable clots. He advised orthopedic surgeons to remove the calcified layer to increase adherence clots. Also, patients should be non-weight bearing to avoid subchondral stiffness, Kelly 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. – by Kristine Houck, MA, ELS

Reference:

Kelly JD IV. Microfracture is only good for small defects. Presented at: Orthopedics Today Hawaii 2014; Jan. 19-23, 2014; Wailea, Hawaii.

Disclosure: Kelly has no relevant financial disclosures.