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Pellegrino M, Trinchese E, Bisaccia M, et al. Long-term outcome of grade III and IV chondral injuries of the knee treated with Steadman microfracture technique. Clin Cases Miner Bone Metab. 2017;13(3):237-240doi: 10.11138/ccmbm/2016.13.3.237.
Pellegrino, M., Trinchese, E., Bisaccia, M., Rinonapoli, G., Meccariello, L., Falzarano, G., Medici, A., Piscitelli, L., Ferrara, P., & Caraffa, A. (2016). Long-term outcome of grade III and IV chondral injuries of the knee treated with Steadman microfracture technique. Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases, 13(3), 237-240. https://doi.org/10.11138/ccmbm/2016.13.3.237
Pellegrino, Marco, et al. "Long-term outcome of grade III and IV chondral injuries of the knee treated with Steadman microfracture technique." Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases vol. 13,3 (2016): 237-240. doi: https://doi.org/10.11138/ccmbm/2016.13.3.237
Pellegrino M, Trinchese E, Bisaccia M, Rinonapoli G, Meccariello L, Falzarano G, Medici A, Piscitelli L, Ferrara P, Caraffa A. Long-term outcome of grade III and IV chondral injuries of the knee treated with Steadman microfracture technique. Clin Cases Miner Bone Metab. 2016 Sep-Dec;13(3):237-240. doi: 10.11138/ccmbm/2016.13.3.237. Epub 2017 Feb 10. PMID: 28228789; PMCID: PMC5318179.
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Clin Cases Miner Bone Metab. 2016 Sep-Dec;13(3):237-240. doi: 10.11138/ccmbm/2016.13.3.237. Epub 2017 Feb 10.

Long-term outcome of grade III and IV chondral injuries of the knee treated with Steadman microfracture technique.

Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases

Marco Pellegrino, Ermanno Trinchese, Michele Bisaccia, Giuseppe Rinonapoli, Luigi Meccariello, Gabriele Falzarano, Antonio Medici, Luigi Piscitelli, Pellegrino Ferrara, Auro Caraffa

Affiliations

  1. Division of Orthopedics and Trauma Surgery, University of Perugia, "S. Maria della Misericordia" Hospital, Perugia, Italy.
  2. Department of Medical and Surgical Sciences and Neuroscience, Section of Orthopedics and Traumatology, University of Siena, University Hospital "Santa Maria alle Scotte", Siena, Italy.
  3. U.O.C. Orthopedics and Traumatology, Azienda Ospedaliera "Gaetano Rummo", Benevento, Italy.

PMID: 28228789 PMCID: PMC5318179 DOI: 10.11138/ccmbm/2016.13.3.237

Abstract

INTRODUCTION: The aim of our study is to demonstrate the effectiveness of Steadman microfracture technique in the management of high-grade chondral defects at the level of the knee by clinical follow-ups at eleven years.

MATERIALS AND METHODS: This is a study conducted on fifteen patients suffering from Outerbridge grade III and IV chondral lesions of the knee, who underwent Steadman microfracture surgery between 2003 and 2004. Selective exclusion criteria to prevent that other treatments or comorbidities could invalidate the results were used. Patients were clinically evaluated with Lysholm and IKDC scale scores before surgery and at follow-ups at eleven years.

RESULTS: There has been an improvement in the Lysholm scores (59.33 ± 18.2 at time zero

DISCUSSION: Currently microfracture surgery is not indicated in patients with high-grade chondral defects, but at the same time, it is a technique of easy execution, low cost and good results. The clinical improvement observed appears statistically significant, but we have also noticed a slight clinical worsening in two patients, possibly caused by: improper treatment, new trauma, incorrect rehabilitation and age at time of surgery.

CONCLUSIONS: The study has shown significant clinical improvements in patients, despite the fact that indications to the use of microfracture are still very limited and selective. It's essential to underline the importance of the single patient assessment process, taking into account a variety of aspects including the site, the number and extent of the lesion, the degree of functionality, activity level, age and previous trauma. This shows the importance of a comprehensive assessment of the patient in order to choose the most suitable surgical option, which not necessarily has to strictly adhere to standard practice.

Keywords: Steadman microfracture; grade III and IV chondral; knee; long-term outcome; technique Outerbridge classification

Conflict of interest statement

Conflict of interest statement All authors must disclose any financial and personal relationships with other people or organisations that could inappropriately influence (bias) their work. Examples of

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