Saumya Orthocare: Centre for Advanced Surgeries of the Knee Joint, Ahmedabad, India.
Arthroscopy. 2013 Sep;29(9):1579-88. doi: 10.1016/j.arthro.2013.05.027.
Although many newer cartilage repair techniques have evolved over the past 2 decades, microfracture is still being advocated as the first line of treatment. Therefore it is timely to conduct a comprehensive review of the literature to assess and report on the current status of Level I and II evidence studies related to microfracture techniques.
A literature search was carried out for Level I and II evidence studies on cartilage repair using the PubMed database. All the studies that dealt with microfracture techniques were selected.
Fifteen studies that involved microfracture techniques met the inclusion criteria of this review article, with 6 long-term and 9 short-term studies. These studies compared the clinical outcomes of microfracture with those of other treatments such as autologous chondrocyte implantation and osteochondral cylinder transfers. The majority of the studies reported poor clinical outcomes, whereas 2 studies reported the absence of any significant difference in the results. Small-sized lesions and younger patients showed good results in the short-term. However, osteoarthritis and treatment failures were observed at later postoperative periods of 5 to 10 years.
The use of microfracture for the treatment of small lesions in patients with low postoperative demands was observed to result in good clinical outcomes at short-term follow-up. Beyond 5 years postoperatively, treatment failure after microfracture could be expected regardless of lesion size. Younger patients showed better clinical outcomes.
Level II, systematic review of Level I and II studies.
尽管在过去的 20 年中出现了许多更新的软骨修复技术，但微骨折仍然被提倡作为一线治疗方法。因此，及时对文献进行全面回顾，评估和报告与微骨折技术相关的 I 级和 II 级证据研究的现状是适时的。
使用 PubMed 数据库对软骨修复的 I 级和 II 级证据研究进行文献检索。选择所有涉及微骨折技术的研究。
本综述文章纳入了 15 项涉及微骨折技术的研究，其中 6 项为长期研究，9 项为短期研究。这些研究比较了微骨折技术与自体软骨细胞移植和骨软骨圆柱移植等其他治疗方法的临床结果。大多数研究报告了较差的临床结果，而 2 项研究报告了结果没有显著差异。小面积病变和年轻患者在短期随访中表现出良好的结果。然而，在术后 5 至 10 年的后期，观察到骨关节炎和治疗失败。
对于术后需求低的小病变患者，使用微骨折治疗可在短期随访中获得良好的临床结果。无论病变大小如何，术后 5 年以上，微骨折治疗失败都可能发生。年轻患者表现出更好的临床结果。
II 级，对 I 级和 II 级研究的系统评价。
