What is the knee microfracture success rate? For a procedure that’s become a mainstay of the modern orthopedic treatment of holes in knee cartilage, we have little high level evidence that the procedure is effective. Hard to believe?
Micro fracture is where the surgeon pokes holes in the bone to stimulate cartilage growth. The procedure involves extensive downtime, works better in younger patients under age 45, and the cartilage that’s produced isn’t high quality. More concerning is a recent review of many studies that shows the effects, despite the invasiveness of the surgery, are short lived.
This research review in the Journal Arthroscopy reviewed 15 higher quality research papers that had been published about the effectiveness of microfracture. These studies usually compared the outcomes (how well patients fared) of microfracture to other cartilage repair techniques. Their conclusions? The majority of the studies reported poor clinical outcomes and two reported no improvements in the treated patients. Small-sized lesions and younger patients showed good results in the short-term. However, treatment failure could be expected within 5 years even in patients with small cartilage lesions.
The upshot? When you look at the high quality studies published on microfracture, despite its widespread use, it doesn’t work well. So why are we still performing this surgery?