Failed Microfracture or Other Cartilage Repair Procedure
Microfracture is the surgical repair of damaged articular cartilage, where small holes are drilled in the underlying bone to create a path for blood flow to the damaged area to promote healing. The articular cartilage does not have any blood supply and therefore lacks the healing property. This method brings stem cells and other growth-stimulating factors to the damaged area to promote the repair or regrowth of the cartilage tissue. However, in the long run, cartilage repair can deteriorate as the blood clot that forms at the site of the injury may not mature adequately, leading to a cartilage repair that is not durable. The same can be said of other cartilage repair procedures such as injection of lubricating material, stem cells and growth factors into the joint, grafting of stem cell paste, cells grown in culture, cartilage plugs, and complete cartilage transfer.
For the microfracture technique to be durable, it must be augmented with other cartilage repair methods. One such procedure would be to add bone paste and stem cells to the microfracture, as well as inject lubricating agents and growth factors into the joint approximately 3 months later. This procedure provides a favorable and long lasting outcome.