KNEE ARTHRITIS - Bone marrow stimulation :
Microfracture for damaged knee cartilage - - Posted by bhitt54 (bhitt54), 29 October 2002
HI,
I recently read an article about Terrell Davis having a type of knee surgery where they drill holes into the bone and let the bones bleed leaving a scab which serves as a cushion between bones that serves in essense as replacement cartilage. THis may allow him to return to football. I guess he has to have one knee done at a time. Does anyone know the name of this surgical procedure and where I can find information on it?
THanks,
Bruce
Posted by hmaxwell (Heather M.), 29 October 2002
Bruce,
I believe Terrell Davis was treated by Dr. Richard Steadman in Vail, CO using the microfracture technique. I'm seeing Dr. Steadman in the next week or so, hoping he can come up with a plan to salvage my knee....
Here is a link to the Steadman Hawkins clinic, with info on the microfracture technique.
http://www.steadman-hawkins.com/knee_microfracture/overview.asp
If the link doesn't work, go to www.steadman-hawkins.com and click on the patient education link in the upper right hand corner.
Good luck.
Heather
Posted by lbdeharak (Linda), 29 October 2002
Hello Bruce,
Heather is correct. He had the Microfracture surgery done at Steadman Hawkins. He will be able to have the other knee done once the first knee heals enough to bear his weight. he was trying to decide between ACI surgery and the Microfracture. He chose the microfracture since it has a shorter healing and rehab time. It does not have as good long term results as ACI, but he is more interested in another year of Football right now. I heard that he has had cells sent to Boston for ACI later.
It will be awhile before he knows how things will go. He says that he is in less pain now though.
Linda
Posted by admin (The KNEEguru), 1 November 2002
Microfracture is similar to, but not the same as, drilling. Drilling is the older procedure, also called sometimes the 'Pridie Procedure'. A drill is used to make little tunnels through the damaged area up into the bone marrow a few mms deeper. The idea is that the bone marrow cells, 'stem cells', grow into the new area, and being undifferentiated cells they try to assume the appropriate local characteristics and turn themselves into cartilage. The problem is that they actually become fibrocartilage, not true cartilage, and this is both less strong and inclined to be exuberant in its growth. Also the drill can cause heating and burning of the local area, so a new technique (very simple) was developed, called microfracture, where instead of drilling a small pick is used and small holes picked, rather than drilled, to reach the bone marrow. The issue with microfracture is that the patient needs to be very careful to not fully weight bear for up to three months to give the joint surface enough time to really heal over with the new cells, and this seems to be where the failures occur, as people are often too impatient. Also CPM post op seems important (having the knee on the continuous passive motion machine).
KNEEguru
Posted by bhitt54 (bhitt54), 22 November 2002
Thanks for all the replys. Linda mentioned an ACI surgery. How is that different from microfracture? Is it cartilage transplant or cartilage regeneration? I was in an auto accident in March 2001. The accident broke my left leg, left me with only 1/2 knee cap and sheared off some of the bone on the left side of my knee. This left me with no cartilage on the left side of my knee. When the bone heeled it left a small crack or space that ruled out transplantion. The doctor is saying that I would be a candidate for a new knee or unicompartmental surgery in 10-15 years after I develop arthritis. I experience soreness in the knee and can't walk like I use to. I guess I'm exploring other options. Any suggestions? 
Bruce
Updated Thu Apr 29 2010
