Microfracture & Mosaicplasty: Cartilage Repair Techniques
At birth, humans are covered with hyaline cartilage—a smooth, durable tissue that cushions joints. Unfortunately, hyaline cartilage has very limited self-healing capacity. When damaged—especially after sports injuries—it typically does not regenerate on its own.
Focal cartilage defects can occur in weight-bearing areas of the knee (femoral condyles) or ankle (talus bone). Depending on the size and location of the defect, we may recommend either microfracture or mosaicplasty—two established surgical techniques to restore joint surface integrity. These procedures are usually performed arthroscopically or with mini-open assistance, minimizing tissue trauma.
What Is Microfracture? Who Is It For?
Microfracture is a minimally invasive technique used primarily in young, active patients with small cartilage defects (typically less than 2 cm²).
During the procedure:
- Tiny, controlled fractures are made in the exposed bone beneath the cartilage defect using a specialized awl.
- This releases bone marrow stem cells and growth factors, which form a clot over the defect.
- Over time, this clot matures into fibrocartilage—a repair tissue that, while not as durable as native hyaline cartilage, significantly reduces pain and improves function.
Recovery After Microfracture
- No weight-bearing for 6–8 weeks to protect the healing clot.
- Continuous passive motion (gentle knee or ankle movement) is essential—motion nourishes and stimulates cartilage.
- Physical therapy begins early to maintain range of motion and prevent stiffness.