Osteochondral allograft and microfracture procedures restore patient mobility

Two separate new studies presented at a major medical meeting provide objective scientific evidence that the two most commonly performed cartilage repair techniques are effective at restoring patient mobility and reducing pain.

Patients in both studies, those that had a cartilage and bone grafts and those that had a procedure that encouraged new tissue growth, recovered more knee function and experienced less pain after the procedure. Prior to these results, surgeons had no evidence – apart from their own observations and experience – that these commonly practiced surgeries were effective.

"The research conducted was a prospective analysis of randomly selected patients who sought treatment to repair cartilage damage. One study looked at patients who had osteochondral allograft, while the other followed-up with patients who had a microfracture procedure," said Riley Williams, MD, a co-author of the study and Director of the Hospital for Special Surgery's Institute for Cartilage Repair.

Dr. Williams added that the results of both studies will help doctors to more accurately predict outcomes for patients seeking relief from cartilage pain.

Dr. Williams presented the research at American Academy of Orthopedic Surgeon's (AAOS) annual meeting, February 23-26, 2005 in Washington, DC. The results of "The Microfracture Technique for Treatment of Articular Cartilage Lesions in the Knee: A Prospective Cohort Evaluation," were presented on Specialty Day, February 26th. "A Prospective Analysis of Knee Cartilage Defects Treated with Fresh Osteochondral Allografts," was on exhibit in a scientific poster throughout the event.

The microfracture procedure, which is more commonly used in patients with less knee damage, involves drilling small holes in the knee to induce bleeding, clotting, and thus tissue re-growth. Patients in this study were examined at a minimum of two years after their procedure to assess the short and long-term outcomes of their surgery. The research showed that, in the short-term, the procedure was more effective in patients with a lower body mass index. Also, the knees with "good fill," or tissue repair, indicated more positive outcomes. Overall, however, all patients recovered better knee function after the procedure.

The second study followed patients who had osteochondral allograft for cartilage repair. Patients who had this procedure generally had significant damage to the knee cartilage. This surgery involves implanting a micrograft of bone and cartilage to repair the lesion. At a mean of thirty-two months after the procedure, patients recovered greater knee function and experienced less pain.

In both studies, results were measured by MRI to detect tissue repair and ADL (Activity of Daily Living) scores to assess knee function. The results of both studies provide scientific data that gives surgeons a tool for the first time that can predict a patient's outcome from either procedure.

The Institute for Cartilage Repair was developed by a skilled group of clinicians in response to growing clinical need for more durable cartilage and meniscal repair procedures. It comprises a multidisciplinary team of medical professionals who have focused on the problems of detecting and treating cartilage injury, as well as conducting research, since 1999 when it was know as the Cartilage Study Group.