Analysis of the short term functional results of osteochondral defects in a stable knee treated by arthroscopic debridement and micro fracture technique at 1 year follow up using the lysholm knee scoring scale

Abstract

Introduction: Articular cartilage is a complex tissue with an ability to withstand tremendous forces over many cycles and years, but at the same time it has no ability to heal even after a minor injury. The incidence of articular cartilage injuries varies from 60-66% during routine arthroscopic surgery [1, 2]. Objectives: To analyze the short term functional results of Osteochondral defects in a stable knee treated by Arthroscopic Debridement and Micro fracture technique at 1 year follow up using the Lysholm Knee Scoring Scale. Methodology: Source of data: All the patients with osteochondral injuries who were managed by arthroscopic micro fracture technique, and have come for follow up. All the patients who underwent arthroscopy for suspected intra-articular pathology and were diagnosed intraoperatively with osteochondral defects, and managed by micro fracture. All the patients admitted to SDM Hospital that are scheduled to undergo arthroscopic debridement and micro fracture for osteochondral defects of the knee based on clinical and MRI findings, who fit into inclusion criteria, within a period of 1 year, from November 2012 to October 2013. Conclusion: Articular cartilage injuries are more frequently encountered during routine arthroscopic surgeries of the knee, than thought. Arthroscopic debridement and micro fracture results in an improved functional outcome at 1 year follow up. Marrow stimulation by micro fracture technique does not require any specialized instruments or operative setup, and can be performed in any center where routine arthroscopic surgeries of the knee are done. Arthroscopic debridement and micro fracture is a single staged procedure as compared to Autologous Chondrocyte Implantation. The cost involved in arthroscopic debridement and micro fracture is far less compared to Autologous Chondrocyte Implantation and other cell based procedures. In comparison to other management modalities for osteochondral defects like Mosaicplasty, Autologous Chondrocyte Implantation and other cell based techniques, Micro fracture does not come in the way for repeat surgeries if required. We safely recommend Arthroscopic debridement and Micro fracture technique as a ‘first line’ management for the treatment of osteochondral defects in a stable knee, for lesions less than 4 cm2 in size.