Microfracture: A technique for repair of chondral defects

Abstract

Articular cartilage damage resulting from traumatic injury, tumour or other diseases has poor healing capability due to its highly organised connective and low metabolic activity of the avascular tissue. Many techniques have been used in the past but repair of articular cartilage defects within synovial joints remains challenging. Microfracture is a marrow stimulation technique, to enhance chondral resurfacing by providing a suitable environment for tissue regeneration. Microfracture is a minimal invasive and cheap method with good short-term results especially in young active patients with small cartilage defects. It is becoming the first-line treatment most frequently used in clinic for articular cartilage repair. The current review provides helpful and comprehensive information about the indications, contraindications, surgical procedure of microfracture technique and its potential complications. The arthroscopic awls used in microfracture produces much less thermal necrosis of the bone than would a hand-driven or motorized drill and allow access to virtually the entire joint, whereas access is much more limited when using a drill. There are important future considerations for chondral resurfacing in human and veterinary medicine.