Knee microfracture surgery is a procedure that aims to repair damaged cartilage in the knee by stimulating new cartilage growth. It is often recommended for patients with small to medium-sized cartilage defects who have not found relief through other treatments such as physiotherapy or medications. The procedure involves creating tiny fractures in the underlying bone to encourage the formation of new cartilage, helping to improve knee function and reduce pain.
When is Knee Microfracture Surgery Recommended?
Knee microfracture surgery is primarily considered when cartilage damage disrupts daily activities and non-surgical treatments have been ineffective. It is most suitable for treating localised cartilage defects that cause pain, stiffness, or limited movement.
The procedure can also be an option for early-stage knee osteoarthritis with isolated cartilage lesions, aiming to slow further degeneration. Additionally, it addresses cartilage damage from injuries or trauma, such as those sustained during sports, by promoting new cartilage growth to restore knee function and relieve discomfort.
Key Benefits of Knee Microfracture Surgery
The procedure offers several advantages for patients, particularly those experiencing persistent knee issues affecting daily activities.
Reduces Chronic Pain
The procedure stimulates the formation of fibrocartilage (cartilage-like tissue), which fills damaged areas, reducing friction and pressure within the knee joint. This can alleviate chronic pain that restricts movement.
Enhances Knee Mobility
Restoring cartilage enhances the smoothness of joint movements, which can improve flexibility and range of motion. Patients often find it easier to perform daily tasks such as walking, climbing stairs, and engaging in low-impact exercise after recovery.
Slows Joint Deterioration
Addressing cartilage issues early can help prevent the deterioration that leads to more severe joint conditions. By treating small defects, the procedure can slow the progression of cartilage wear and potentially delay the need for more extensive joint interventions, like total knee replacement surgery, in the future.
Preparing for Knee Microfracture Surgery
Before undergoing knee microfracture surgery, a comprehensive evaluation is necessary to determine if the procedure is suitable for the patient. This typically involves:
Medical Evaluation
An experienced orthopaedic surgeon Singapore assesses knee stability, range of motion, and overall joint health. The patient’s medical history is reviewed, focusing on any previous knee injuries or surgeries, which helps plan the surgical approach.
Imaging Tests (X-rays or MRI)
X-rays are used to evaluate bone structure and joint alignment, while MRI scans provide detailed images of cartilage. These help pinpoint the exact location and extent of the damage, ensuring the procedure targets the specific area needing repair.
Pre-Surgery Guidelines
Routine blood tests assess general health, and adjustments to blood thinners may be needed to minimise bleeding risks. Fasting may be required for general anaesthesia, and patients are advised to avoid strenuous activities before the procedure.
Procedure Overview
Knee microfracture surgery is performed under general or regional anaesthesia and involves several key steps to repair cartilage damage:
Anaesthesia and Pre-Surgical Preparation
Patients receive either general anaesthesia (to be fully asleep) or regional anaesthesia (numbing from the waist down). The chosen method depends on individual health and surgery requirements.
The knee area is cleaned to minimise infection risks, and the leg is positioned for easy access. Diagnostic arthroscopy (a minimally invasive procedure using a small camera to examine the inside of the knee joint) is often performed first to confirm the problem and adjust the surgical plan as needed.
Arthroscopic Access
Small incisions are made around the knee, allowing the insertion of the arthroscope and surgical tools. This enables the surgeon to visualise the joint and locate the damaged cartilage.
Preparing the Cartilage
Loose or damaged cartilage is removed, and the surrounding area is smoothed to prepare the bone surface for effective treatment.
Microfracture Technique
Small perforations are made in the bone beneath the damaged cartilage to trigger blood flow, which releases bone marrow cells. These cells form a clot that promotes the growth of fibrocartilage over time.
Dr Wang typically uses bioaugmentation with collagen scaffold infused with bone marrow aspirate concentration (stem cells) to increase the success of cartilage regeneration.
Closure
After the microfractures are made, the instruments are withdrawn, and the incisions are closed with sutures. A dressing is applied and the knee is wrapped for support during early recovery.
What to Expect During Recovery
Recovery from knee microfracture surgery typically spans several months. In the first 1-2 weeks, patients should rest, avoid weight-bearing, use crutches for mobility, and manage pain with medication and ice. By weeks 3-6, light physical therapy focuses on maintaining flexibility and preventing stiffness. A knee hinge brace to control range of motion may be required for 4-6 weeks.
From months 2-6, weight-bearing exercises are gradually introduced to rebuild strength and improve stability. High-impact activities may remain restricted, depending on the surgeon’s advice. Full recovery usually takes 3-6 months, depending on the extent of damage and adherence to rehabilitation.
Potential Risks and Complications
Knee microfracture surgery is generally safe but carries some risks, including infection, bleeding, blood clots, and joint stiffness. Persistent pain or incomplete cartilage regrowth may occur, especially in larger damaged areas. Rarely, nerve damage or weakness can develop. Following post-operative care and regular monitoring can help minimise these risks and improve recovery outcomes.
Conclusion
Knee microfracture surgery is a minimally invasive option for repairing cartilage damage, offering relief from persistent knee pain and improving joint function when non-surgical treatments have been unsuccessful. By promoting the growth of fibrocartilage, the procedure can enhance mobility and potentially delay the need for more extensive surgeries in the future. Successful outcomes rely on proper preparation, adherence to rehabilitation protocols, and regular follow-ups with your surgeon.
Dr Wang routinely uses the latest cartilage regenerative techniques, including bioaugmentation with stem cells and collagen scaffold (Autologous Matrix Induced Chondrogenesis).
If you’re considering knee microfracture surgery, schedule a consultation with Dr Wang Lushun to discuss your options and develop a tailored treatment plan.
