An Overview on Chondroplasty and Microfracture as
Articular Cartilage Treatments
Articular cartilage is the substance that covers our joints and is responsible for providing a smooth and pain-free gliding motion. If articular cartilage is damaged, or if it begins to degenerate due to a previous injury, pieces of it may break off and become loose within the joint. This creates a situation where further injury is possible from the floating fragment catching between the joint surfaces and further damaging the cartilage. Eventually, the cartilage damage may leave exposed bone resulting in grinding, soreness, stiffness, and a surface that does not glide smoothly. Articular cartilage is one such structure within the joint that is incapable of repairing itself.
However, through new joint restoration and preservation techniques, some skilled orthopedic hip surgeons, such as Austin, Texas based Dr. Jeff Padalecki, have advanced the area of articular cartilage treatment enough to restore damaged cartilage. Chondroplasty and Microfracture are two such techniques that are used to help smooth out damaged, irregular shaped cartilage in order to provide a smoother gliding surface for the joint. Both procedures can be effective in reducing the symptoms associated with the injury and can prevent further propagation of the chondral injury.
Dr. Padalecki is trained to perform arthroscopic chondroplasty. Using several keyhole incisions and a tiny camera to view the inside of the hip joint, Dr. Padalecki reshapes the surface of the hip joint and smooths out irregularities and removes loose pieces of floating cartilage. He also meticulously removes cartilage pieces that have been caught between the surfaces of the joint. This particular approach is successful in patients with small, partial thickness conditions where the damage has not yet reached the bone itself. Many patients are able to resume normal activities with minimal pain.
Following the chondroplasty procedure, Dr. Padalecki may also determine that the Microfracture technique is required in order to promote the growth of cartilage in the injured area of the joint. Microfracture is performed so that a fresh set of marrow cells and blood supply can be introduced to the damaged area of cartilage, which helps promote new cartilage production. During this procedure, the most superficial layer of the exposed bone is removed and small holes are then made in the area of exposed bone creating “microfractures” that allow the bone marrow elements to flow into the joint. These fractures are meant to provide a new source of blood supply and marrow cells for new cartilage growth. In most cases, a layer of fibrocartilage will form to cover the exposed bony defect. This type of cartilage is slightly different than the normal cartilage found in joints but provides relief of symptoms and preservation of the surrounding cartilage in the joint by covering the bone.
The post-op processes following chondroplasty and Microfracture vary but are very important in the overall recovery of the patient. During the recovery time, patients will avoid certain hip motions but will be allowed to move the hip with the guidance of a therapist. Following a chondroplasty (without Microfracture), patients are typically kept on crutches for 3 weeks and then allowed to weight bear as tolerated. After Microfracture, patients are encouraged to avoid full weight bearing on the affected limb for 6 to 8 weeks to provide an optimal environment for the cartilage to fill in.
For more information on articular cartilage treatments, such as chondroplasty and Microfracture, please contact the office of Dr. Jeff Padalecki, Austin, Texas hip surgeon.