Microfracture and ability to return to sports after cartilage surgery

Microfracture is a simple, effective first-line treatment for small articular cartilage defects in the knee joint. The lesions should be isolated to the articular cartilage with no loss of bone and have a circumferential shoulder of intact cartilage. Postoperative rehabilitation involves 4-6 weeks of protected weight bearing and continuous passive motion. Younger, lighter patients with a shorter duration of symptoms have better outcomes after microfracture. Femoral lesions are associated with better outcomes than patellofemoral lesions are. The repair tissue generated by microfracture is fibrous with uncertain durability, especially in more active patients. Athletes can return to sport after articular cartilage surgery, but the data regarding this are relatively limited. Optimal indications, rehabilitation, timing of return to sport, and durability of repair deserve further study in the athletic patient population.