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Clinic
27, 1st avenue, Besant nagar
Chennai 600090, India
Mobile: 00 91 92821 65002
Tel: 00 91 44 24912905,
 
Hospital
Chettinad Health City Rajiv Gandhi Salai, Kelambakkam, Kanchipuram Dist,
Tamil Nadu 603 103, India
T.+91(0)44 27475225,27475959
F. +91 (0)44 2747 5970
 
Email:drvenkat@kneeindia.com
 
 
 
   
 
 
Microfracture
Key hole surgery
Micro fracture is a useful technique for the treatment of small articular cartilage defects ( lesions) in low demand patients. The underlying bone is stimulated to healing by reparative fibro cartilage. Postoperative regimen of CPM (continuous passive motion) for eight hours per day for six weeks is necessary to achieve good results.
Microfracture Technique
The procedure is done through key hole incisions( arthroscopic surgery) A standard arthroscopic evaluation of the knee is done. The size, location, borders and depth of the cartilage lesion is assessed. The rest of the knee is assessed for kissing lesions. Thickness of the neighbouring cartilage is assessed. When the lesion is circumscribed, and at least of grade 3 , then microfracture can be done. It is done with special awls with a titanium carbide tip. Holes are made 3- 4 mm deep at 5 mm intervals till bleeding from the subchondral bone is seen. The tourniquet is released so that bleeding is seen and no drains are left. The portals are better sutured to avoid leaks.
Post op regime
The patient should remain non weight bearing for 6 weeks CPM( continuous passive motion) is done for 6- 8 hrs daily.
Alternative to knee replacement
Cartilage surgery such as Microfracture when done for younger patients with traumatic lesions has yielded good results and will postpone the progression of lesions to osteoarthritis. In older patients with degenerative lesions the prognosis is less durable. Pain relief does occur. Many patients who have undergone this procedure in India are highly pleased as the procedure is least traumatic to the knee with a good degree of success.
Case reports
Please see testimonial from International patients on www.kneeindia.com for the procedure in a middle age American citizen.
Micro fracture and high tibial osteotomy
When malalignment exists and is the basis of degenerative cartilage defects, then a High tibial osteotomy is combined with a microfracture procedure. This case scenario occurs in the setting of Chronic ACL deficiency.