Microfracture treatment of single or multiple articular cartilage defects of the knee: a 5-year median follow-up of 110 patients

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 18; no. 4; pp. 504 - 508
• Main Authors: Solheim, Eirik, Øyen, Jannike, Hegna, Janne, Austgulen, Ove K., Harlem, Thomas, Strand, Torbjørn
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-04-2010; Springer Nature B.V
• Subjects: Adolescent; Adult; Arthroplasty, Subchondral; Cartilage; Cartilage, Articular - injuries; Cartilage, Articular - surgery; Chondrocytes - transplantation; Failure; Female; Follow-Up Studies; Grading; Humans; Knee; Knee Injuries - surgery; Knees; Male; Medicine; Medicine & Public Health; Middle Aged; Multiple Trauma - surgery; Orthopedics; Pain; Pain Measurement; Patients; Prospective Studies; Reoperation; Research Design; scoring; Sports; Surgery; Treatment Failure; Treatment Outcome; Young Adult; Knee; Microfracture; Arthroscopy; Articular cartilage defects
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-009-0974-y

We compared the results of microfracture in single versus multiple symptomatic articular cartilage defects in the knee in 110 patients with a median age of 38 years (range 15–60). Cases of reoperation of the cartilage defect were classified as failures. Clinical outcome in non-failures was evaluated by the Lysholm score and grading of knee pain and function of the knee by the use of patient-administered visual analog scales (VAS; 0–100). Data were prospectively collected before the operation and at the 2- to 9-year follow-up. The single lesion or the largest of multiple lesions were located on the medial femoral condyle (
n
 = 62), trochlea (
n
 = 18), lateral tibia (
n
 = 11), patella (
n
 = 10) or lateral femoral condyle (
n
 = 9). We treated one (
n
 = 76), two (
n
 = 27) or three (
n
 = 7) lesions with a median total area of 4 cm
2
(range 1–15). A total of 24 failures (22%) were registered—18% in the single-defect subgroup and 29% in the multiple-defects subgroup. In the remaining group of patients (
n
 = 86), the mean Lysholm score, mean pain-score (0 = no pain; 100 = worst possible pain) and mean function-score (0 = useless; 100 = full function) improved from 51, 52 and 41, respectively, to 71 (
P
 < 0.001), 30 (
P
 < 0.001) and 69 (
P
 < 0.001) at the follow-up. The pain-score was significant lower (
P
 = 0.042), and the function-score significantly higher (
P
 = 0.001) in the group of patients with a single lesion compared to the group with 2 or 3 lesions. The Lysholm score did not differ significantly between the two subgroups (
P
 = 0.06).