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Bones & Joints
Microfracture is a surgical cartilage repair technique used to treat focal articular cartilage defects (areas of damaged or missing cartilage) in weight-bearing joints—most commonly the knee, but also ankle, hip, and shoulder. The procedure involves creating tiny fractures (microfractures) in the bone beneath the cartilage defect using a sharp awl, which stimulates bone marrow stem cells to migrate into the defect and form fibrocartilage 'scar tissue' to fill the void. While not as durable as native hyaline cartilage (original smooth joint cartilage), fibrocartilage provides reasonable load distribution and pain relief in 70-80% of patients at 2-5 years post-op. Microfracture is best suited for: focal defects less than 2-4 square cm, patients under 40 years, high-activity individuals wanting to avoid or delay joint replacement, acute traumatic cartilage injuries (not degenerative arthritis). Recovery requires strict non-weight-bearing for 6-8 weeks to allow fibrocartilage to form without being crushed, making this a demanding rehab but worthwhile for carefully selected patients wanting joint preservation.
What it is and why it happens
Microfracture is a surgical cartilage repair technique used to treat focal articular cartilage defects (areas of damaged or missing cartilage) in weight-bearing joints—most commonly the knee, but also ankle, hip, and shoulder. The procedure involves creating tiny fractures (microfractures) in the bone beneath the cartilage defect using a sharp awl, which stimulates bone marrow stem cells to migrate into the defect and form fibrocartilage 'scar tissue' to fill the void. While not as durable as native hyaline cartilage (original smooth joint cartilage), fibrocartilage provides reasonable load distribution and pain relief in 70-80% of patients at 2-5 years post-op. Microfracture is best suited for: focal defects less than 2-4 square cm, patients under 40 years, high-activity individuals wanting to avoid or delay joint replacement, acute traumatic cartilage injuries (not degenerative arthritis). Recovery requires strict non-weight-bearing for 6-8 weeks to allow fibrocartilage to form without being crushed, making this a demanding rehab but worthwhile for carefully selected patients wanting joint preservation.