Microfracture Versus Arthroscopic Debridement for the Treatment of Symptomatic Cartilage Lesions of the Knee: 2-Year Results From a Multicenter Double-Blinded Randomized Controlled Trial.

BACKGROUND

Knee cartilage injuries can lead to significant functional limitations, pain, and diminished quality of life. Microfracture (MF) is the most common surgical procedure for smaller (<2 cm2) cartilage lesions of the knee. However, there is no established gold-standard surgical intervention.

PURPOSE: To compare functional and patient-reported outcomes after MF and arthroscopic debridement (AD) for symptomatic, isolated femoral cartilage injuries <2 cm2 in patients aged 18 to 50 years.

STUDY

DESIGN

Randomized controlled trial; Level of evidence, 1.

METHODS

A total of 65 patients were included, randomized to undergo either MF (n = 31) or AD (n = 34), and followed for 2 years. The primary outcome was the change in the Knee injury and Osteoarthritis Outcome Score (KOOS) Quality of Life subscore. Secondary outcomes included scores for the other KOOS subscales, Tegner activity scale, Lysholm score, and visual analog scale for pain.

RESULTS

The mean age at the time of inclusion was 33.2 ± 9.7 years. There were 44 (68%) male patients. The mean size of the lesion was 1.2 ± 0.6 cm2. There was no statistically significant difference between the groups in the change in the KOOS Quality of Life subscore from baseline to 2 years (3.5 [95% CI, -10.0 to 16.9]; P = .61). There were 10 complications in 5 patients in the MF group and 2 complications in 2 patients in the AD group. According to a linear mixed model, there were no statistically significant differences between the groups for any of the secondary outcomes at any time point during the 2-year follow-up period.

CONCLUSION

MF was not superior to AD when treating femoral cartilage lesions of the knee <2 cm2.