Microfracture is an arthroscopic procedure performed to repair damaged knee cartilage for patients with cartilage injuries or only a minimal amount of damage. This procedure often helps patients avoid or postpone the need for knee replacement surgery while effectively relieving pain and swelling in the affected area. The cartilage is necessary to cushion the area and allow for smooth, painless movement. Microfracture is most commonly performed in athletes who may have suffered cartilage injuries while playing sports.
During the microfracture procedure, a small surgical tool called an awl is inserted into the damaged area of the knee to create small holes, known as microfractures, in the bone near the damage to help release the cells that produce cartilage and restore the damaged area. The number of holes created may vary depending on the size and location of the area being treated, with most patients requiring five to 15 small holes.
Patients will need to undergo physical therapy after this procedure, and many are able to resume playing sports and other physical activities within a few months. Stimulation of a certain type of cartilage known as fibrocartilage will likely occur after microfracture, which can provide long-term pain relief but may require additional treatment in the future.
The Osteoarticular Transfer System, commonly known as OATS, replaces damaged cartilage in the knee with healthy cartilage from another area of the joint, relieving pain and restoring movement and function to the joint. A mosaicplasty is the name for a general procedure that treats severe cartilage damage, and the OATS procedure is one type of mosaicplasty.
Although cartilage is essential to smooth, painless movement of the joints, some areas have a more critical need for the support and cushioning provided by the cartilage. During the OATS procedure, small plugs of healthy cartilage are removed from areas of the joint that are not in critical need, and transferred to the area of damaged cartilage.
The OATS procedure is ideal for patients with small areas of cartilage damage that can be easily repaired with a graft. Widespread cartilage damage cannot usually be treated with this procedure, since there may be insufficient amounts of healthy cartilage available.
After the OATS procedure, patients will need to undergo a lengthy physical therapy program in order to restore range of motion and relieve pain and swelling on the joint. Most patients will be on crutches for 6 to 12 weeks after surgery before they can successfully bear weight on the joint again. Long-term follow-up care will be required in order to maintain the results of this procedure.
An estimated 70 million Americans suffer from chronic pain. Chronic pain is a major medical condition distinctly different and more complex than acute pain. While acute pain is a normal sensation triggered in the nervous system to alert one to possible injury, chronic pain is a state in which pain persists for many months or years, beyond the normal course required by healing of an injury. The economic and personal losses associated with chronic pain can be significant, including costly medical expenses, lost income and productivity; lost mobility, anxiety or depression.
The causes of chronic pain are not always clear. Past traumatic injuries, congenital conditions, cancers, arthritis, and others might point to an obvious culprit, but in many cases the source of chronic pain can be very complex. This makes it difficult to treat, and pain management usually does not involve one approach, but a multidisciplinary focus designed to help the patient reach his or her highest level of function and independence.
Depending on the individual, pain management programs can include the following components:
The most successful pain management programs are those that are specifically tailored for an individual so that the patient can be actively engaged in his or her own recovery with the support of medical and social networks.
Partial knee replacement may be possible for patients with damage to one part of the joint. Doctors refer to this limited damage as a Unicompartmental knee or "Uni" knee. In a partial knee replacement, only the diseased parts of the knee are removed and replaced; the healthy portions are left untouched. Successful partial knee replacements can delay or eliminate the need for a total knee replacement. They also allow a greater range of movement than standard (non-high-flex) total knee replacements.
Benefits of partial knee replacement surgery include a smaller incision (2-3 inches), shorter hospital stay (often 24 hours or less), and faster recovery and rehabilitation.