Midterm Clinical and Radiological Results after Microfracture in Osteoarthritic Knees

Dae Kyung Bae; Kyoung Ho Yoon; Sang Jun Song; Jung Ho Noh; Man Ho Kim

doi:10.4055/jkoa.2008.43.6.752

Journal List > J Korean Orthop Assoc > v.43(6) > 1012858

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Bae, Yoon, Song, Noh, and Kim: Midterm Clinical and Radiological Results after Microfracture in Osteoarthritic Knees

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2008; 43(6): 752-759.

Published online: 31 December 2008

DOI: https://doi.org/10.4055/jkoa.2008.43.6.752

Midterm Clinical and Radiological Results after Microfracture in Osteoarthritic Knees

Dae Kyung Bae, M.D., Kyoung Ho Yoon, M.D., Sang Jun Song, M.D., Jung Ho Noh, M.D., Man Ho Kim, M.D.

Department of Orthopedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea.

Address reprint requests to Dae Kyung Bae, M.D. Department of Orthopedic Surgery, School of Medicine, Kyung Hee University, 1, Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea. Tel: +82.2-958-8366, Fax: +82.2-964-3865, bdkyung@khmc.or.kr

Abstract

Purpose

To evaluate midterm results after microfracture in osteoarthritic knees.

Materials and Methods

Between October 1997 and April 2006, 67 osteoarthritic knees, with minimum 4-year follow-up, underwent microfracture. Baumgaertner scores were evaluated to determine clinical results. Radiological results were assessed based on joint space widening and improvement of mechanical axis deviation. Joint space widening was calculated by comparing the preoperative joint space with the final follow-up joint space. Varus deformity was evaluated on orthoroentgenogram and recorded as a percentile of the point at which the mechanical axis intersected a line extending from the center of the knee to medial border of the medial tibial condyle. The figure was expressed as MA%.

Results

The average Baumgaertner score at final follow-up was 7.0. The average joint space changed from 2.74 mm to 4.22 mm on AP radiographs and from 1.91 mm to 3.85 mm on lateral radiographs. Average MA% was 57.5% preoperatively and 45.8% at final follow-up. Clinical and radiological improvements were maintained in most cases followed for more than 4 years. Four patients had total knee arthroplasty after an average of 4.1 years.

Conclusion

We noted pain relief, joint space widening, and improvement of mechanical axis after microfracture for degenerative arthritis of the knee. Maintenance of clinical and radiological improvement was observed at midterm follow-up.

Keywords: Knee, Osteoarthritis, Arthroscopy, Microfracture

Figures and Tables

Fig. 1

(A) Joint space on the AP radiograph was measured by the distance between the medial femoral condyle and the midpoint from medial tibial spine to medial border of the medial tibial condyle. (B) Joint space on the lateral radiograph was measured by the nearest of distance between medial femoral condyle and medial tibial plateau.

Fig. 2

The extent of varus deformity shown on preoperative orthoroentgenogram was evaluated by MA% [(b/a)×100]. It shows a medial deviation of the mechanical axis with joint space narrowing of medial compartment: (a) is the distance from the center of the knee to the medial border of the medial tibial condyle and (b) is the distance from the center of the knee to the point at which the mechanical axis intersects the knee joint line.

Fig. 3

Preoperative radiographs of fifty five-year-old woman with symptomatic degenerative osteoarthritis on right knee. (A) AP gap was 2.21 mm on anterior-posterior view of the knee. (B) Lateral gap was 1.19 mm on lateral view of the knee. (C) MA% was 99.8% on orthoroentgenogram.

Fig. 4

Radiographs 4 years after microfracture of fifty five-year-old woman with symptomatic degenerative osteoarthritis on right knee. (A) AP gap was 4.40 mm on anteriorposterior view of the knee. (B) Lateral gap was 2.48 mm on lateral view of the knee. (C) MA% was 52.1% on orthoroentgenogram.

Table 1

Baumgaertner's Nine-point Scale

Table 2

Baumgaertner Score, AP Gap, Lateral Gap, and MA% in Patients with Follow-up for More Than 4 Years

^*, Post-operative; ^†, not available.

Table 3

AP Gap, Lateral Gap, and Mechanical Axis Percentage (MA%) according to Preoperative MA%

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