ORTHOPEDICS/HIP & KNEE/SURGICAL TECHNIQUES
About Micro-Crack Surgery
A micro-crack also called micro-fracture is a new technique that consists creating small holes in the bone in order to penetrate the hard bone coating allowing the deeper, more vascular bone to access the joint surface. This deeper bone possesses a more rich blood supply, and the cells can then get to the coating surface to motivate cartilage growth.
When a patient suffers of a partial damaged cartilage (and not widespread arthritis), a micro-fracture may be performed in an attempt to motivate new cartilage growth.
Micro-crack is most frequently performed inside the knee joint, although it has also been considered for therapy in other joints including the hip, ankle, and shoulder.
Micro-Crack Surgery Good Candidate
Good Candidate for a micro-crack surgery are:
- Patients with restricted cartilage damage zones
- Active patients that cartilage injuries deprive them performing their activities.
- Patients with pain or inflammation caused by the damaged cartilage zone
Micro-Crack Surgery Disqualified Candidate
- Patients with widespread (complete) joint arthritis
- Patients with joint unsteadiness or mal-alignment
- Inactive Patients who
- Patients with inflammatory arthritis (such as rheumatoid arthritis)
- Patients indisposed to contribute in a recovery following a micro-crack surgery.
Micro-Crack Surgery/Performance
Micro-crack surgery can be an excellent process, providing considerable pain relief when done to the good candidate.
One of the worries with micro-crack surgery is that it does not stimulate the growth of normal joint cartilage.
Knowing that there are numerous cartilage types, and one of these types known by “Hyaline” cartilage is normally found on the joint surface.
Micro-crack surgery motivates the growth of a cartilage type frequently found in scar tissue (fibrocartilage).
Different from the Hyaline cartilage, fibrocartilage does not have the same cartilage strength and resiliency that are normally found in a joint; therefore, there is a chance that the cartilage stimulated by a micro-crack process will not last long.
A micro- crack surgery is usually performed as a part of an Arthroscopic knee surgery.
Note that other joints can also be treated correspondingly by arthroscopic surgery.
Micro-crack surgery has been performed in the hip, ankle, shoulder, elbow, and other joints in the body.
Performance
1- the zone undergoing a micro-crack surgery is prepared by removing the damaged cartilage.
Preferably, this zone undergoing micro-crack surgery should not exceed about two centimeters in diameter and should possess good and healthy surrounding cartilage.
2- A small, sharp pick tool is used to generate the small micro-crack holes in the bone. The number of these holes depends on the size of the treated zone. (Usually, one to two centimeters damaged zone necessitate five to fifteen small holes in the bone).
3- The penetration of the bone outer coatings permits blood and stem cells to shape a clot in the damaged cartilage zone. These cells will shape the new cartilage coating within the damage.
Appropriate recovery following the micro-crack surgery is one of the keys to a successful therapy.
Recovery plan must shield the treated zone, in addition to maintaining the knee joint strength and mobility.
Consequently, patients are advised to use supports after a micro-crack surgery.
Generally, a knee brace is recommended, and in some states, a motion machine to curve the knee may be used.
Recap
Micro-crack surgery of the knee joint is a safe practice with minimal risks.
In fact, inflammation, blood clot, stiffness, and distension of the knee joint are very rare after a micro-crack surgery.
Micro-Crack Surgery/Results
In the short to mid-term, generally, people who undergo a micro-crack surgery do practically well.
The only concern is about the micro-crack repair durability.
Most specialists approve that the cartilage that heals within a micro-crack process is not almost as durable as normal cartilage.
For that reason, the long-term consequences of a micro-crack surgery are not very satisfactory, and people who undergo this surgical technique may finish by having difficulties with the arthritis progression over the time.
Micro-Crack Surgery/Options
Commonly, good candidates for micro-crack surgery fracture are also good candidates for other therapies options concerning a knee cartilage damage.
These options include cartilage transfer and cartilage implantation.
While almost all these options that address the damaged cartilage have similar results, the risks and costs of a micro-crack surgery have shown being intensely less; therefore, micro-crack surgery is mostly considered the first therapy option for a knee joint cartilage damage.