Rehabilitation following microfracture surgery lower. If you are undergoing knee surgery in houston, your surgeon may also need to perform a microfracture. Articular cartilage defects of the knee diagnosis and treatment e. The three main types of surgical technique microfracture surgery and similar.
Microfracture surgery is one of the surgical procedures available to try and heal knee cartilage injuries. Microfracture surgery is an orthopedic surgical technique used to restore damaged knee cartilage, the material that helps cushion bones at the joints. The surgical goal was to produce microfractures in the subchondral bone perpendicular to the surface and to be able to reach all areas of the joint with the instruments. Reviewed by carol scottconner, md, phd, mba university of. Joint preservation techniques cartilage restoration. Ankle arthroscopy with microfracture for osteochondral. Click below to watch a video of this surgical technique. Federal law usa restricts this device to sale by or on the order of a. This procedure uses minced pieces of cartilage seeded over a. There are different rehabilitation protocols in existence, as unfortunately, it is not known how best to rehabilitate from this type of surgery.
Ankle arthroscopy with microfracture for osteochondral defects of the talus suman medda, m. Treatment of osteoarthritis of the knee with microfracture. Autologous matrixinduced chondrogenesis geistlich pharma. This unique singlestep procedure combines the microfracturing method, which is an established firstline. It is frequently performed on professional athletes and is becoming increasingly common for all types of patients. Arthroscopic microfracture of hip chondral lesions.
Treatment of osteoarthritis of the knee with microfracture and rehabilitation. Microfracture of femoral condyle surgery rehab protocol. The oats procedure consists of grafting a section of articular cartilage from a nonweight bearing area to the defect of concern. The current study compares mf to microdrilling md in a rabbit model and also examines the effect of hole depth on repair responses. Dexterity and speed in tying knots correctly constitute an art which only practice can make. Microfracture surgery is an articular cartilage repair surgical technique that works by creating tiny fractures in the underlying bone. Microfracture surgery rehabilitation what is articular cartilage. I found basic surgical techniques so helpful that ive recommended it highly and gifted it to other med students. It plays an extremely important role in supporting nearly the entire weight of the body and does this with the help of surrounding muscles, ligaments and cartilage.
Microfracture surgical technique hybrid fibrohybrid fibrohyaline repair tissue with hyaline repair tissue with limited collimited col ii and ii and aggrecanaggrecan contentcontent microfracture clinical efficacy. Avoid scar mobilization on surgical portals x 4 weeks or per md. This causes new cartilage to develop from a socalled superclot. Microfracture repair of the knee with any of the following indications. No study has compared the effectiveness of these techniques.
Postoperative rehabilitation is an important factor in achieving a successful outcome from a microfracture procedure. This book fills a gap in surgical techniques for cartilage repair. The learning curve was short for the hip arthroscopist, and the increase in surgical time was minimal with the procedure. Regular manual treatment should be conducted to decrease the incidence of fibrosis. Microfracture is a technically simple and costeffective treatment option for articular cartilage lesions of the knee. Those holes allow bone marrow stem cells to enter and cover the cartilage defectsee pictures below. Weight bearing in full extension for 4 weeks postop.
Microfracture should not follow previous surgical techniques used to repair the cartilage lesion. Kelley and firesteins textbook of rheumatology tenth edition, 2017. The arthroscopic technique of microfracture was developed and its value demonstrated in clinical patients by steadman et al. We work directly with knee arthroscopists to develop and innovate techniques and technologies that will enable every. At sharp, we understand that after microfracture surgery you need time to regain your strength. Pdf atlas of cardiac surgical techniques a volume in the. This allows stem cells and bone marrow elements to migrate to the bone surface and promote cartilage repair. Check out other translated books in french, spanish languages. The use of a machine to bend the knee called a continuous passive motion or cpm machine is recommended for 68 hours per day for 6 weeks after surgery. Microfracture is a surgical technique that has been developed to treat chondral defects, which are damaged areas of articular cartilage of the knee. Microfracture is a surgical technique to treat full thickness defects or loss of the articular surface of a joint, usually the knee joint.
Microfracture knee surgery microfracture knee surgery. Microfracture is a surgical procedure aimed at cartilage regeneration. The refined technique of the handling and uniting the tissues in the case of manual skills is attainable by many practices, and the good surgeon works on the perfection of this technique in his daily operating activities. Return to sports is often delayed for 6 to 9 months after surgery.
Were here to support you and work with you on your road to recovery. Surgical technique patient setup the patient is placed supine on the operating room. Microfracture is a bone marrow stimulation procedure and is based on the puncturing of the subchondral bone plate into the bone. Filling them with repair tissue can relieve pain, improve function and delay or prevent the need for surgery later on. Microfracture for cartilage injuries of the knee howard. Arthroscopic microfracture, oats cartilage procedure in. Complications reported with microfracture surgery include general surgical complications infection, blood clot, incisional irritation. The microfracture technique stimulates cartilage growth by drilling multiple, tiny holes in the defect. Download atlas of cardiac surgical techniques and read atlas of cardiac surgical techniques online books in format pdf. Microfracture involves drilling tiny holes in the bony layer under the defect, where a blood clot forms and eventually fibrocartilage. Arthrex provides products, including the powerpick, allowing surgeons to effectively perform microfracture surgery safely and reproducibly. The surgery is quick typically lasting between 3090 minutes, minimally invasive, and can have a significantly shorter recovery time than an arthroplasty knee replacement. Evaluation of microfracture of traumatic chondral injuries. To learn basic surgical techniques surgical scrubbing gowning and gloving for surgery basic suturing techniques treatment of various wounds appropriate antibiotic use treatment of burns.
The microfracture surgical technique was developed by the senior author and. Microfracture technique for fullthickness chondral defects. Microfracture of hip chondral lesions has been performed for more than a decade with modified treatment principles and techniques from knee arthroscopy. Microfracture surgery is an articular cartilage repair surgical technique that works by creating. Wear a knee brace locked in full extension for 4 weeks unless otherwise instructed. My skill came not from any intrinsic abilities of my own but rather from knowing how things were supposed to be done and what to pay attention to, which this book taught me. Operative techniques in orthopaedics volume 7, issue. The aim of rehabilitation is early joint motion, maintaining muscle strength and protection of the healing cartilage defect.
Complications specific to the microfracture technique are poor tissue differentiation or repair, and osteophyte formation. A comparative study of microfracture and drilling surgical. Surgery books download thousands of surgery books pdf. Microfracture is a single stage arthroscopic procedure that can be used in conjunction with other arthroscopic treatments for the treatment of osteoarthritis of the knee. Cartilage restoration can be achieved using different techniques. Pdf smalldiameter awls improve articular cartilage repair after. Enhanced microfracture techniques in cartilage knee surgery. It is a common procedure used to treat patients with full thickness damage to the articular cartilage that goes all the way down to the bone.
Microfracture can be done using an arthroscope a long, thin device with a. Microfracture surgery, in essence, attempts to repair a hole in knee cartilage that causes painful boneonbone contact by creating a new injury and allowing the body to heal itself. The knee has cartilage that covers the ends of each bone, particularly the femur thigh bone. The main function of your cartilage is to protect the bone and allow the joint surfaces easily to slide over each other to ensure smooth movement. Non weight bearing status for 4 weeks postop resting foot on floor and driving are okay. Microfracture surgery is appropriate for patients having single lesion and healthy subchondral bone. The arthroscopic technique involves clearing damaged tissue from the knee joint and creating tiny holes microfractures in the bone area where the cartilage is defective. The microfracture technique has been demonstrated to be an effective arthroscopic treatment for fullthickness chondral lesions and joints with degenerative lesions. A microfracture is an arthroscopic small incision knee surgery technique which involves making multiple small holes in the bone. The reverse microfracture technique proposed in this study proved to be a simple and reproducible procedure, without any additional associated costs or.
This marrowbased strategy has produced a durable cartilaginous repair tissue when proper surgical techniques and postoperative rehabilitation protocols are followed. Microfracture to the trochlea surgery rehab protocol. The book and accompanying videos provide good value and should be helpful for medical students and possibly some firstyear residents. Chondral resurfacing of articular cartilage defects in the knee with the microfracture technique. Microfracture protocol for patients sharp rehabilitation. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Microfracture is a simple but cost effective method to. Knee microfracture result deteriorates over time in young.
Cartilage restoration oats, microfracture, allograft. Vertebral compression fractures in osteoporotic and pathologic bone. Gobbis team looked at 170 athletic patients with at least 10 years of followup data who underwent microfracture procedures between 1991. We then discuss the special considerations to be taken regarding the use. Knee surgery arthroscopic and open procedures arthrofibrosis is a condition of the appendicular skeletal system that has resulted from disease, injury, or surgery, and results in pain and restricted range of motion due to internal scarring of the joint with consequent stiffness. To view all 5000 books, please click the button bewlow. Microfracture technique forfullthickness chondral defects.
Pdf enhanced microfracture techniques in cartilage knee. Both microfracture techniques improved cartilage repair compared. Reviewed by carol scottconner, md, phd, mba university of iowa hospitals and clinics. Arthroscopic microfracture for osteochondritis dissecans. Rohrich and daniel mckee and menyoli malafa, journalplastic and reconstructive surgery, year2015. Microfracture knee surgery patient information sheet the knee joint the knee is a very important joint in the body and consists of the thigh bone femur and shin bone tibia. Chens surgical technique for osteochondral allograft transplantation of the medial femoral condyle with orthobiologic augmentation and graftrecipient microfracture preparation has been featured in arthroscopy techniques the journal of arthroscopic and related surgery. Appropriate candidates for microfracture surgery have been defined as young individuals with isolated lesions, no degenerative changes, and normal knee alignment. This technique is typically indicated for patients with unstable stage ii or iii lesions that are unsuitable for fragment. Depending on the location of the articular cartilage defect and subsequent graft, patients may have active andor passive range of motion restrictions this will be noted on the prescription. Microfracture surgery is an articular cartilage repair technique performed by creating small fractures in the underlying bone in order for new fibrocartilage to form.
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