Microfracture The microfracture technique is a further elaboration of the drilling technique. The biggest advantage of the microfracture over the drilling or abrasion chondroplasty is the fact that it can be performed arthroscopically. In fact the open surgery and the associated morbidity and a prolonged recovery were the bane of the drilling and abrasion treatments which never became widespread. Very small micro-holes generated be distributed across the entire articular cartilage lesion site, at a distance of 3–4 mm apart and down to a depth of 4 mm, thus yielding about 3–4 holes per square centimeter. Since the holes drilled are considerably smaller (approximately 0.5–1.0 mm in diameter) than those created by Pridie, this method disturbs the biomechanics of the joint much less severely. The technique is mostly performed to relieve pain, and is successful in 75% of all cases. Microfracture and autologous chondroplast transplantation yielded the same clinical results 2 years after the operation.   This is the view of the arthroscopic microfracture operation being performed with instruments shown on the right. Image credit: Orthop Clin N Am 36 (2005) 419 – 426   To receive microfracture treatment the patient has to be younger than 60 years old, and to be able to follow a strict and rigorous rehabilitation protocol. The malaligned knee is also a contraindication . The procedure involves debridement of the unstable cartilage, followed by the microfracture itself. The patient starts to feel better only 6 months after the operation, and improvement occurs within 2 years after the procedure. The complications of the microfracture include pain and a discomfort in the knee which should stop after several weeks. Sometimes the knee also locks, often because of the tissue that grew in the response to the procedure in the trochlear groove.   back to top