title: Results at 10-14 years after microfracture treatment of articular cartilage defects in the knee.
abstract: OBJECTIVE
  To evaluate the long-term clinical outcome after microfracture treatment of focal chondral defects of the knee and to investigate possible early determinants of the outcome.
  
  
  METHODS
  A prospective cohort of 110 patients, treated with microfracture, was evaluated at a median of 12 years (range 10-14) by Lysholm score, VAS of knee function and VAS of knee pain. Pre- and perioperative information was collected, and additional surgery to the same knee during the follow-up period was recorded. Analysis of variance and paired t test were used for comparison of the long-term data to results from the baseline examination and a former 5-year (midterm) follow-up evaluation.
  
  
  RESULTS
  Forty-three patients needed additional surgery to the knee including seven knee replacements. Fifty had a poor long-term outcome-defined as a knee replacement surgery or Lysholm score below 64. A poor result was more common in subgroups with mild degenerative changes in the cartilage surrounding the treated defect, concurrent partial meniscectomy, poor baseline Lysholm score or long-standing knee symptoms. The Lysholm score, function VAS and pain VAS all significantly improved from the baseline values to the mean scores of 65 (SD 24), 65 (SD 24) and 31 (SD 24), respectively, at the long-term evaluation. The long-term scores did not differ significantly from the midterm scores.
  
  
  CONCLUSIONS
  The outcome scores improved significantly from baseline to the long-term evaluation and were not different from the midterm outcome. Still, a normal knee function was generally not achieved, and many patients had further surgery. The results call for more research and, at present, caution in recommending microfracture in articular cartilage defects, especially in subgroups with worse prognosis.
  
  
  METHODS
  Case series, Level IV.
authors.affiliation: Department of Orthopaedics, Deaconess University Hospital, Haraldsplass, 5009, Bergen, Norway. eirik.solheim@uib.no.|Teres Bergen, Bergen, Norway. eirik.solheim@uib.no.|Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway. eirik.solheim@uib.no.
authors.forename: Eirik
authors.initials: E
authors.lastname: Solheim
authors.affiliation: Teres Bergen, Bergen, Norway.
authors.forename: Janne
authors.initials: J
authors.lastname: Hegna
authors.affiliation: Department of Orthopaedics, Deaconess University Hospital, Haraldsplass, 5009, Bergen, Norway.|Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
authors.forename: Eivind
authors.initials: E
authors.lastname: Inderhaug
authors.affiliation: National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway.
authors.forename: Jannike
authors.initials: J
authors.lastname: Øyen
authors.affiliation: Department of Orthopaedics, Deaconess University Hospital, Haraldsplass, 5009, Bergen, Norway.
authors.forename: Thomas
authors.initials: T
authors.lastname: Harlem
authors.affiliation: Department of Orthopaedics, Deaconess University Hospital, Haraldsplass, 5009, Bergen, Norway.
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Strand
mesh_terms: D000293:Adolescent; D000328:Adult; D019645:Arthroplasty, Replacement, Knee; D054544:Arthroplasty, Subchondral / Q000379:methods*; D002357:Cartilage Diseases / Q000601:surgery*; D002358:Cartilage, Articular / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012086:Reoperation; D055815:Young Adult
keywords: Arthroscopy; Articular cartilage defects; Knee; Microfracture