The most commonly performed procedures for treating chondral defects are Shaving and Microfracture Surgery. Dr. Millett will choose the appropriate surgical course of action based on the size of the defect as well as the location in the knee, the age and weight of the patient, the activity level of the patient and other assessments surrounding the medical condition of the knee.
Shaving (or Debridement) Surgery
During this arthroscopic surgery, Dr. Millett will smooth the shredded or frayed articular cartilage. This common treatment intended for patients where the cartilage defect has not worn all the way down to the bone, leads satisfactory results for over 75% of patients. For patients with arthritis and osteoarthritis, this treatment options works well when other resurfacing techniques are not appropriate. Ideally, the smoothing and shaving away of the damaged cartilage helps to ultimately decrease friction and irritation, thus reducing the symptoms of swelling, noise, and pain.
Microfracture (or Abrasion) Surgery
Microfracture is a well-accepted and successful technique that encourages the growth of new cartilage into the knee chondral defect. This procedure is performed arthroscopically and is a common knee surgery for patients with damage through the full thickness of articular cartilage, all the way down to the bone. During the procedure, the base of the damaged area is scraped to create a bleeding bed of bone, because blood is crucially essential for healing. Dr. Millett will then poke very tiny holes into the defect with a special instrument. This allows the patient’s blood vessels and bone marrow cells to come into contact with the exposed cartilage defect. Bone marrow then fills the defect helping to stimulate the production of new cartilage. Research has shown that this tissue is a hybrid cartilage. Although this newly grown cartilage is durable and can function for many years, it may not have the same durability or strength as the original cartilage that existed before the injury.
After Articular Cartilage Surgery
Rehabilitation after knee surgery can be a lengthy process involving a limitation of activities, physical therapy and rest that will need to take place for a period of months. Specific rehabilitation will vary according to each patient’s needs and you must adhere to your own protocol as established by Dr. Millett and your physical therapist.