2025 ISAKOS Biennial Congress ePoster
Comparison of radiologic and clinical outcomes between microfracture and microdrilling on cartilage defects of distal femur
Junwoo Byun, MD, Seoul KOREA, REPUBLIC OF
Min Jung, MD, PhD, Seoul KOREA, REPUBLIC OF
Hyun-Soo Moon, MD, PhD, Seoul KOREA, REPUBLIC OF
Kwangho Chung, MD, Seoul KOREA, REPUBLIC OF
Se-Han Jung, MD, Seoul KOREA, REPUBLIC OF
Sung-Hwan Kim, MD, PhD, Seoul KOREA, REPUBLIC OF
Yonsei university college of medicine, Seoul, KOREA, REPUBLIC OF
FDA Status Not Applicable
Summary
Microdrilling resulted in a better functional and radiologic outcomes compared to microfracture
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Abstract
Introduction
Marrow stimulation procedure is a cost-effective procedure for cartilage defects of knee. Microfracture and microdrilling is both a commonly used technique for marrow stimulation. Microfracture is advocated for the absence of possible thermal damage to subchondral bone while microdrilling has its advantage of avoiding impaction of subchondral bone which could be a threat to the patency of subchondral channel. The purpose of this study was to evaluate the radiologic and clinical outcomes between microdrilling and microfracture on femoral condyle. We hypothesize that microfracture has inferior radiologic and functional outcome compared to microdrilling.
Methods
Patients who had marrow stimulation procedure for cartilage defects of distal femur cartilage defects from March 2010 to February 2022 and had follow up MRI postoperatively were included. Patients who had concurrent osteotomy or ligament surgery was excluded. Demographic data such as age, BMI, sex, affected side were included. Data of preoperative alignment, size and position of the cartilage lesion was collected. Radiologic outcome was evaluated by MOCART score. Preoperative and postoperative Lysholm, IKDC subjective score, VAS pain score, KOOS score was analyzed.
Results
68 patients were included, and 43 patients had microfracture. There was no significant difference in preoperative demographic data, and size of the lesion. MOCART score was significantly higher in microfracture group, and among the variables of MOCART score, volume fill of cartilage defect and integration into adjacent cartilage was significantly higher. Subgroup analysis for cartilage sized under 2cm2, also showed significant difference in the aforementioned variables. Clinical outcomes at the time of 2 years follow up showed higher proportion of patients achieving improvement of IKDC subjective score beyond MCID.
Conclusion
Microdrilling showed a better outcome regarding MOCART score compared to microfracture. Among the variables of MOCART score, volume of cartilage filling and integration into adjacent cartilage showed superior result. For patients with size below 2.0cm2, volume filling, integration to adjacent cartilage and total MOCART score was also significantly higher in microdrilling group. Microdrilling resulted in higher proportion of patients with improvement beyond MCID for IKDC subjective score.