Micro-fracture surgery: What is it & why is it needed

HEALTH WATCH: DR. NIRAV K. PANDYA

   Not a week goes by in sports without the public hearing on ESPN about a profes- sional athlete who undergoes micro-fracture surgery. But what exactly is micro-fracture surgery?

   In order to understand the surgery, you first have to understand what dissipates shock and keeps joints moving smoothly in the body: hyaline cartilage. This material is the covering on the ends of bones; allowing joints to glide through their range of motion and absorb stress from the wear and tear of sports.

   Not surprisingly, this cartilage can get damaged, leading to pain, swelling, and stiffness in joints (i.e. knee and ankle). If the injury is bad enough that small craters of exposed bone are formed, it can potentially mean the end of one’s athletic career.

   Micro-fracture is a surgical technique done through a camera (arthroscope) in which small holes (“fractures”) are created at the ends of the bones which have these cartilage defects. These little holes cause the bone to bleed; bringing in new cells which can form new cartilage (not as good as the original but still better than nothing!) in the defects.

   After the surgery, patients have to take several months off of sporting activity to allow the new car- tilage to form. If successful, patients have a good chance of returning to sports with what would have otherwise been a career altering injury.

Dr. Nirav K. Pandya is a pediatric orthopedic surgeon specializing sports injuries at the Children’s Hospital in Oakland.