Nanofracture is a procedure whereby a tiny 'pick' is used to make holes through the bone plate under the joint cartilage, to encourage stem cells to enter the area and repair the defect.


Comparison of nanofracture with microfracture

The pick is smaller than the microfracture pick. A 'needling' technique may also be used, passing a needle into the bone via a cannulated nanofracture pick.


A simple flowchart with links to show the possible interventions in cases of knee arthritis.

Discussion looking at the alternatives to a joint replacement in active patients whose osteoarthritis tends to be limited.



Reviewing subchondral cartilage surgery: considerations for standardised and outcome predictable cartilage remodelling. Benthien JP and Behrens P. Int Orthop. 2013 Nov; 37(11): 2139–2145.

See also -


eBook on alternatives to joint replacement

Knee arthritis interventions when you are too young for a total knee replacement - ebook