Microfracture May Keep Athletes in the Game

Microfracture is an effective first-line treatment for knee articular cartilage lesions in athletes who participate in high-impact sports, Dr. Kai Mithoefer and associates reported.

Microfracture is a relatively simple technique in which penetration of the subchondral bone induces clot formation containing marrow-derived mesenchymal stem cells, which produce a mixed fibrocartilage repair tissue containing varying amounts of type II collagen. It has become a popular treatment option for knee articular cartilage lesions in athletes, due to its low associated morbidity and rapid postoperative rehabilitation time.

Outcome data on athletes who perform high-impact sports with marked mechanical demands have been limited, said Dr. Mithoefer of Harvard Vanguard Orthopedics and Sports Medicine and Brigham and Women's Hospital, Boston, and associates (Am. J. Sports Med. 2006;34:1413–8).

The study population comprised 32 patients, mean age 38, with single cartilage lesions of the femur. Their mean symptom duration was 28 months. All had regularly participated in high-impact, pivoting sports, including basketball (14), tennis (13), football (9), downhill skiing (7), and soccer (5). All underwent microfracture arthroplasty performed by a fellowship-trained orthopedic surgeon. Seven patients with meniscus tears also received partial meniscectomy.

At a mean follow-up of 41 months, 21 of the athletes reported good or excellent results on the Brittenberg rating of knee function; significant improvements were seen on the activity-based Marx activity rating scale and Tegner scores. Improvements occurred in the activities of daily living scale in 71% of patients, on the Marx scale in 58%, and in Tegner scores in 72%. After an initial increase, declines in activity scores were observed in 15 athletes, Dr. Mithoefer and associates reported.

A total of 14 athletes (44%) returned to participation in high-impact sports after microfracture. Functional outcome score increases were lower among those who did not return to the sport. Two-thirds of the patients who had been symptomatic for 12 months or less before microfracture were able to return to their high-impact sport, compared with just 14% who had been symptomatic for more than a year before the procedure.

Athletes who received microfracture as first-line treatment were far more likely to return to their sports than were those who had had previous procedures, but concomitant meniscectomy did not have a significant impact on the ability to return to the sport. Patients with lesions of 200 mm

Microfracture is an effective first-line treatment for knee articular cartilage lesions in athletes who participate in high-impact sports, Dr. Kai Mithoefer and associates reported.

Microfracture is a relatively simple technique in which penetration of the subchondral bone induces clot formation containing marrow-derived mesenchymal stem cells, which produce a mixed fibrocartilage repair tissue containing varying amounts of type II collagen. It has become a popular treatment option for knee articular cartilage lesions in athletes, due to its low associated morbidity and rapid postoperative rehabilitation time.

Outcome data on athletes who perform high-impact sports with marked mechanical demands have been limited, said Dr. Mithoefer of Harvard Vanguard Orthopedics and Sports Medicine and Brigham and Women's Hospital, Boston, and associates (Am. J. Sports Med. 2006;34:1413–8).

The study population comprised 32 patients, mean age 38, with single cartilage lesions of the femur. Their mean symptom duration was 28 months. All had regularly participated in high-impact, pivoting sports, including basketball (14), tennis (13), football (9), downhill skiing (7), and soccer (5). All underwent microfracture arthroplasty performed by a fellowship-trained orthopedic surgeon. Seven patients with meniscus tears also received partial meniscectomy.

At a mean follow-up of 41 months, 21 of the athletes reported good or excellent results on the Brittenberg rating of knee function; significant improvements were seen on the activity-based Marx activity rating scale and Tegner scores. Improvements occurred in the activities of daily living scale in 71% of patients, on the Marx scale in 58%, and in Tegner scores in 72%. After an initial increase, declines in activity scores were observed in 15 athletes, Dr. Mithoefer and associates reported.

A total of 14 athletes (44%) returned to participation in high-impact sports after microfracture. Functional outcome score increases were lower among those who did not return to the sport. Two-thirds of the patients who had been symptomatic for 12 months or less before microfracture were able to return to their high-impact sport, compared with just 14% who had been symptomatic for more than a year before the procedure.

Athletes who received microfracture as first-line treatment were far more likely to return to their sports than were those who had had previous procedures, but concomitant meniscectomy did not have a significant impact on the ability to return to the sport. Patients with lesions of 200 mm

Microfracture is an effective first-line treatment for knee articular cartilage lesions in athletes who participate in high-impact sports, Dr. Kai Mithoefer and associates reported.

Microfracture is a relatively simple technique in which penetration of the subchondral bone induces clot formation containing marrow-derived mesenchymal stem cells, which produce a mixed fibrocartilage repair tissue containing varying amounts of type II collagen. It has become a popular treatment option for knee articular cartilage lesions in athletes, due to its low associated morbidity and rapid postoperative rehabilitation time.

Outcome data on athletes who perform high-impact sports with marked mechanical demands have been limited, said Dr. Mithoefer of Harvard Vanguard Orthopedics and Sports Medicine and Brigham and Women's Hospital, Boston, and associates (Am. J. Sports Med. 2006;34:1413–8).

The study population comprised 32 patients, mean age 38, with single cartilage lesions of the femur. Their mean symptom duration was 28 months. All had regularly participated in high-impact, pivoting sports, including basketball (14), tennis (13), football (9), downhill skiing (7), and soccer (5). All underwent microfracture arthroplasty performed by a fellowship-trained orthopedic surgeon. Seven patients with meniscus tears also received partial meniscectomy.

At a mean follow-up of 41 months, 21 of the athletes reported good or excellent results on the Brittenberg rating of knee function; significant improvements were seen on the activity-based Marx activity rating scale and Tegner scores. Improvements occurred in the activities of daily living scale in 71% of patients, on the Marx scale in 58%, and in Tegner scores in 72%. After an initial increase, declines in activity scores were observed in 15 athletes, Dr. Mithoefer and associates reported.

A total of 14 athletes (44%) returned to participation in high-impact sports after microfracture. Functional outcome score increases were lower among those who did not return to the sport. Two-thirds of the patients who had been symptomatic for 12 months or less before microfracture were able to return to their high-impact sport, compared with just 14% who had been symptomatic for more than a year before the procedure.

Athletes who received microfracture as first-line treatment were far more likely to return to their sports than were those who had had previous procedures, but concomitant meniscectomy did not have a significant impact on the ability to return to the sport. Patients with lesions of 200 mm