Colegio Mexicano de Ortopedia y Traumatología

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sábado, 7 de septiembre de 2013

Evidence-Based Status of Microfracture Technique: A Systematic Review of Level I and II Studies

http://www.ncbi.nlm.nih.gov/pubmed/23992991?goback=%2Egde_3834520_member_271540116#%21


Evidence-Based Status of Microfracture Technique: A Systematic Review of Level I and II Studies. 
Goyal D, Keyhani S, Lee EH, Hui JHP
http://www.ncbi.nlm.nih.gov/pubmed/23992991

The use of microfracture for the treatment of small lesions in patients with low postoperative
demands was observed to result in good clinical outcomes at short-term follow-up. Beyond 5 years postoperatively,
treatment failure after microfracture could be expected regardless of lesion size. Younger patients showed
better clinical outcomes.

Evidence-Based Status of Microfracture Technique: A Systematic Review...ncbi.nlm.nih.gov

PubMed comprises more than 23 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

 2013 Sep;29(9):1579-88. doi: 10.1016/j.arthro.2013.05.027.

Evidence-Based Status of Microfracture Technique: A Systematic Review of Level I and II Studies.

Source

Saumya Orthocare: Centre for Advanced Surgeries of the Knee Joint, Ahmedabad, India. Electronic address: deepak@knee.in.

Abstract

PURPOSE:

Although many newer cartilage repair techniques have evolved over the past 2 decades, microfracture is still being advocated as the first line of treatment. Therefore it is timely to conduct a comprehensive review of the literature to assess and report on the current status of Level I and II evidence studies related to microfracture techniques.

METHODS:

A literature search was carried out for Level I and II evidence studies on cartilage repair using the PubMed database. All the studies that dealt with microfracture techniques were selected.

RESULTS:

Fifteen studies that involved microfracture techniques met the inclusion criteria of this review article, with 6 long-term and 9 short-term studies. These studies compared the clinical outcomes of microfracture with those of other treatments such as autologous chondrocyte implantation and osteochondral cylinder transfers. The majority of the studies reported poor clinical outcomes, whereas 2 studies reported the absence of any significant difference in the results. Small-sized lesions and younger patients showed good results in the short-term. However, osteoarthritis and treatment failures were observed at later postoperative periods of 5 to 10 years.

CONCLUSIONS:

The use of microfracture for the treatment of small lesions in patients with low postoperative demands was observed to result in good clinical outcomes at short-term follow-up. Beyond 5 years postoperatively, treatment failure after microfracture could be expected regardless of lesion size. Younger patients showed better clinical outcomes.

LEVEL OF EVIDENCE:

Level II, systematic review of Level I and II studies.
Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.