Summary: Rate of RTP of professional athletes after microfracture in the knee is very high - The ability to continue playing reduces over time but shows no difference compared to non-injured athletes, but is affected by the size and number of lesions requiring microfracture.

Background

Injuries to the knee are common in elite athletes and often involve damage to the articular cartilage. Given the high demands of elite sport, articular cartilage defects in the knee can be career limiting or threatening. Microfracture can promote cartilage repair, but the resultant mixed fibrocartilaginous tissue is believed to be less resilient than the native hyaline cartilage. Doubts remains as to whether it can withstand prolonged and intensive sporting activity and has become less popular.

Hypothesis/Purpose
The primary aim of this study was to determine the factors affecting return to play (RTP) and continued participation in elite sport by athletes after microfracture of the knee. The secondary aim was to compare 2 and 5 year “still playing” rates in soccer and rugby players with matched controls.

Study Design and Methods
A retrospective review of a consecutive series of elite athletes with chondral injuries in the knee treated with microfracture by the lead surgeon between 2011 and 2020 was undertaken. RTP was defined as competing in at least one event at professional level or national/international level in amateur sport. A control group (5 to 1) of non-injured soccer and rugby players matched for age, league level, field position and minutes played was compiled to compare 2 and 5 year “still playing” rates.

Results

Fifty athletes with a mean age of 24.7 years (± 4.0 years) were included. 30 (60.0%) were soccer players and13 (26%) were rugby players. Forty-seven (94%) athletes RTP at a mean time of 9.3 months (± 4.1months) and 43 (91.5%) of these were still playing at 2 years. At 5 years, 24 (61.5%) of the athletes were still playing professional sport. The size of the lesion showed a significant effect on RTP (p=0.048) and continuing to play at 5 years (p=0.037) but was not significant at 2 years. The number of lesions significantly affected playing at 2 and 5 years (p<0.001).
Thirty one soccer and rugby players had full match appearance data available and were therefore compared with the control group. ”Still playing” rates demonstrated no statistically significant difference compared to the matched control group at either 2 years (87.1% vs 91.5% p=0.496) or 5 years (53.6% vs 70.3%) p=0.122).

Conclusion

Rate of RTP of professional athletes after microfracture in the knee is very high. The ability to continue playing reduces over time but shows no difference compared to non-injured athletes, but is affected by the size and number of lesions requiring microfracture.

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Return To Play And Continued Participation In Elite Sport After Microfracture For Chondral Lesions In The Knee – A Matched Controlled Cohort Study

Return To Play And Continued Participation In Elite Sport After Microfracture For Chondral Lesions In The Knee – A Matched Controlled Cohort Study

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Return To Play And Continued Participation In Elite Sport After Microfracture For Chondral Lesions In The Knee – A Matched Controlled Cohort Study

Return To Play And Continued Participation In Elite Sport After Microfracture For Chondral Lesions In The Knee – A Matched Controlled Cohort Study

Background

Results

Conclusion

More 2025 ISAKOS Congress Content