Abstract
Marrow stimulation has been performed for more than 45 years beginning with the simple
drilling of bony surfaces, burring or “abrading” the sclerotic lesion, and more recently
using awls to penetrate eburnated bone to promote blood flow to the bony surface.
Multiple authors have promoted these procedures as “helpful,” but others have confirmed
only short-term relief with destruction of the subchondral surface. Unfortunately,
proponents do not compare their marrow stimulation results to a control group that
had debridement alone. A recent study confirmed that microfracture (MF) is equivalent
to debridement and does not affect the subchondral bone, which therefore does not
reduce the success rates of future surgery subsequent to MF. This brief review summarizes
some of the factual data showing that marrow stimulation may not offer any improvement
over debridement alone and that, in fact, MF results in significant destruction to
the subchondral bone.
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Article info
Publication history
Accepted:
December 18,
2014
Received:
December 18,
2014
Footnotes
The author reports that he has no conflicts of interest in the authorship and publication of this article.
See commentary on page 506
Identification
Copyright
© 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- The New Microfracture: All Things ConsideredArthroscopyVol. 31Issue 6
- PreviewMicrofracture, as introduced by Drs. Steadman and Rodkey, contributed a great deal in the pursuit of cartilage repair. They carefully described their patient and pathologic selection, surgical technique, and reported the long-term outcomes.1 They initially introduced their procedure for partial-thickness traumatic cartilage lesions that did not penetrate the calcified layer. The purpose was to access the subchondral bone vascularity that presumably carried pluripotential cells. Subsequently, they expanded their method to include Grade IV, full-thickness, end-stage lesions.
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