Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up.

Abstract

PURPOSE:

In this study, we measured functional outcomes of patients treated arthroscopically with microfracture for full-thickness traumatic defects of the knee.

TYPE OF STUDY:

A case series of patients with 7 to 17 years' follow-up.

METHODS:

Between 1981 and 1991, a total of 72 patients (75 knees) met the following inclusion criteria: (1) traumatic full-thickness chondral defect, (2) no meniscus or ligament injury, and (3) age 45 years and younger (range, 13 to 45 years). Seventy-one knees (95%) were available for final follow-up (range, 7 to 17 years). All patients completed self-administered questionnaires preoperatively and postoperatively.

RESULTS:

The following results were significant at the P <.05 level. Significant improvement was recorded for both Lysholm (scale 1 to 100; preoperative, 59; final follow-up, 89) and Tegner (1 to 10; preoperative, 3; final follow-up, 6) scores. At final follow-up, the SF-36 and WOMAC scores showed good to excellent results. At 7 years after surgery, 80% of the patients rated themselves as "improved." Multivariate analysis revealed that age was a predictor of functional improvement.

CONCLUSIONS:

Over the 7- to 17-year follow-up period (average, 11.3 years), patients 45 years and younger who underwent the microfracture procedure for full-thickness chondral defects, without associated meniscus or ligament pathology, showed statistically significant improvement in function and indicated that they had less pain.

Steadman Hawkins Sports Medicine Foundation, Vail, Colorado 81657, USA.

Dr. Kelly Cunningham

Austin Ortho + Biologics

Sports can be rough on joints and cartilage, especially shoulders, knees, and hips. Kelly Cunningham, MD, has cared for many young and mature athletes whose joints take a beating day in and day out. He welcomes patients from Austin, Texas, and its surrounding communities to experience the cutting-edge technology and skill offered by his team at Austin Ortho + Biologics.

Dr. Cunningham works with each athlete to develop an individual treatment plan that emphasizes the least invasive treatments possible with a goal of minimal recuperation and downtime. He combines rigorous standards and quality of care with experience and insight, integrating the best new techniques into the care of each patient.

His patients have included skilled athletes in football, basketball, baseball, and hockey, including members of the Dallas Cowboys at their Austin training camp, Austin Ice Bats hockey players, Southwestern University athletes, and many other colleges and high school athletes. He served for 15 years as a traveling team physician for the men’s alpine downhill US Olympic Ski Team, providing on-the-hill medical race coverage in North America and Europe, including qualifying races for the Winter Olympics.

As a sports medicine specialist, Dr. Cunningham also treats many seasoned weekend warriors such as runners, skiers (downhill, snowboard, and water), and tennis and golf enthusiasts.

After medical school and residency training in Dallas, he completed a sports medicine/knee fellowship with renowned orthopedic specialist Dr. Richard Steadman in Vail, Colorado, and underwent further shoulder training in England and Canada.

While with Dr. Steadman, the originator of the popular microfracture cartilage treatment technique, he developed a strong interest in the care of cartilage injuries and now has more than 20 years of experience with surgical microfracture and related procedures. In recent years, he has closely monitored cutting-edge techniques as they’re developed for use in these acute and chronic problems.

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