Randsborg Per-Henrik, Aae Tommy Frøseth, Visnes Håvard, Birkenes Thomas, Benth Jūratė Šaltytė, Lian Øystein Bjerkestand, Hanvold Heidi Andreassen, Årøen Asbjørn
Department of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Norway.
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Am J Sports Med. 2025 Jun 26;53(9):3635465251346961. doi: 10.1177/03635465251346961.
Knee cartilage injuries can lead to significant functional limitations, pain, and diminished quality of life. Microfracture (MF) is the most common surgical procedure for smaller (<2 cm) cartilage lesions of the knee. However, there is no established gold-standard surgical intervention.
To compare functional and patient-reported outcomes after MF and arthroscopic debridement (AD) for symptomatic, isolated femoral cartilage injuries <2 cm in patients aged 18 to 50 years.
Randomized controlled trial; Level of evidence, 1.
A total of 65 patients were included, randomized to undergo either MF (n = 31) or AD (n = 34), and followed for 2 years. The primary outcome was the change in the Knee injury and Osteoarthritis Outcome Score (KOOS) Quality of Life subscore. Secondary outcomes included scores for the other KOOS subscales, Tegner activity scale, Lysholm score, and visual analog scale for pain.
The mean age at the time of inclusion was 33.2 ± 9.7 years. There were 44 (68%) male patients. The mean size of the lesion was 1.2 ± 0.6 cm. There was no statistically significant difference between the groups in the change in the KOOS Quality of Life subscore from baseline to 2 years (3.5 [95% CI, -10.0 to 16.9]; = .61). There were 10 complications in 5 patients in the MF group and 2 complications in 2 patients in the AD group. According to a linear mixed model, there were no statistically significant differences between the groups for any of the secondary outcomes at any time point during the 2-year follow-up period.
MF was not superior to AD when treating femoral cartilage lesions of the knee <2 cm.
膝关节软骨损伤可导致严重的功能受限、疼痛及生活质量下降。微骨折术（MF）是治疗膝关节较小（<2 cm）软骨损伤最常用的外科手术。然而，目前尚无公认的金标准手术干预方法。
比较18至50岁有症状的孤立性股骨软骨损伤<2 cm患者接受MF和关节镜下清创术（AD）后的功能及患者报告结局。
随机对照试验；证据等级，1级。
共纳入65例患者，随机分为MF组（n = 31）或AD组（n = 34），随访2年。主要结局指标为膝关节损伤和骨关节炎疗效评分（KOOS）生活质量子量表的变化。次要结局指标包括其他KOOS子量表评分、Tegner活动量表评分、Lysholm评分及疼痛视觉模拟量表评分。
纳入时的平均年龄为33.2±9.7岁。男性患者44例（68%）。损伤的平均大小为1.2±0.6 cm。两组从基线到2年时KOOS生活质量子量表的变化无统计学显著差异（3.5 [95%CI，-10.0至16.9]；P = 0.61）。MF组5例患者出现10例并发症，AD组2例患者出现2例并发症。根据线性混合模型，在2年随访期内的任何时间点，两组在任何次要结局指标上均无统计学显著差异。
治疗膝关节<2 cm的股骨软骨损伤时，MF并不优于AD。
