Houston Methodist. Leading Medicine

Knee News

A New Breakthrough in Treating Torn Knee Cartilage

This study shows that surgical treatment of one particular knee injury is worth it, even years later. Seventy-two patients were included in a study at the Steadman-Hawkins Sports Medicine Foundation in Vail, Colorado. All subjects had an injury of the articular cartilage in the knee. Articular cartilage is the smooth covering over the surface of the bone inside the knee joint. Articular cartilage allows the parts of the knee to glide smoothly during movement.

In all the patients, there were no torn ligaments or a damaged meniscus in the knee. However, the cartilage was torn all the way down to the bone. This is called a full-thickness tear. Everyone in the study was treated arthroscopically. This means the doctor didn't cut the joint open. Instead, a long, slender tool called an arthroscope was inserted through small puncture holes in the skin. A tiny TV camera at the end of the scope allows the doctor to see the inside of the joint on a screen.
In this procedure, all defects in the cartilage are removed. A special tool called an awl is used to make holes in the bone around the edge of the healthy cartilage. This technique is called arthroscopic microfracture. Pain and swelling eventually decrease with this treatment. Activity level and function improve or at least stays the same. The authors report that patients under age 35 generally do better than patients over 35.

Even seven years after the surgery, 80 percent of the patients rated their results as "improved." Most of the positive changes took place in the first year. Many patients continued to improve up to three years after the operation. The authors conclude that microfracture combined with rehab therapy gives the best results for full-thickness cartilage tears. Age is a factor that should be considered.

J. Richard Steadman, MD, et al. Outcomes of Microfracture for Traumatic Chondral Defects of the Knee: Average 11-Year Follow-up. In Arthroscopy. May/June 2003. Vol. 19. No. 5. Pp. 477-484.


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