Feb 19, 2008
Microfracture helps athletes with arthritis
In discussing treatment options for a knee that's been worn out from
the rigors of an active lifestyle, the suggestion of placing small
holes into the joint to help it heal might seem like adding insult to
injury. Yet, just such a procedure — called "Microfracture" — is
gaining in popularity as a safe, effective and less painful
alternative to arthroscopic knee replacement surgery says Dr. Kevin
Plancher, a sports orthopaedist from Greenwich.
"Microfracture has become more prevalent over the past several years,
because it offers patients a speedy, minimally invasive surgical
experience, a faster and more comfortable recovery than that of knee
replacement surgery, and a substantial success rate of about 85%,"
said Dr. Plancher in a press release. He is an official orthopaedic
surgeon for the U.S. Ski Snowboard teams.
The Microfracture procedure involves using a pointed awl to poke
small holes in the bones of the joint where the cartilage has been
worn away. Blood and bone marrow, rich with stem-cells, seep out of
the fractures and create blood clots that release cartilage-building
cells. The body's normal immune response to what it perceives as an
injury completes the task of rebuilding the cartilage in the treated
area. The procedure takes about 30 minutes, and the entire healing
and rehabilitative process takes approximately four to six months.
Microfracture was developed nearly 20 years ago by Dr. Richard
Steadman of the Steadman-Hawkins Clinic in Vail, Colo. After an 11-
year follow-up study published in the June, 2003 issue of the journal
Arthroscopy, Dr. Steadman and his colleagues proved that
Microfracture was as safe and effective as other treatments, even
over the long term.
"This procedure is ideal for younger patients who are very active,
and wish to return to their sport or activity as quickly as
possible," Dr. Plancher said. "The best candidates for Microfracture
are those patients whose cartilage degeneration is limited to small
areas in the knee, and who are willing to commit to a fairly rigorous
physical therapy regimen afterward in order to restore full
functioning in the joint."
For these reasons, many of the patients who choose Microfracture as
an alternative to knee replacement surgery are professional athletes
such as Jason Kidd of the New Jersey Nets and Steve Yzerman of the
Detroit Red Wings.
The rehabilitation process for Microfracture usually takes one-half
to one-third of the time that a surgical knee-replacement procedure
does, but it begins as soon as the procedure is completed.
"Depending upon the location and the size of the area being treated,
passive range-of-motion exercises might be initiated the same day as
the treatment or a day later because gentle motion will actually
stimulate the development of the cartilage," Dr. Plancher said. "The
motion exercises might be done by the patient, a physical therapist,
or with the use of a passive motion machine. In fact, some patients
use the CPM machine nightly during sleep to speed the cartilage-
building process. Weight-bearing, however, is usually limited for six
weeks after the procedure, as pressure on the joint could harm the
regenerating cartilage.
Dr. Plancher is a leading orthopaedic surgeon and sports medicine
expert with extensive practice in knee, shoulder, elbow and hand
injuries. Dr. Plancher is an associate clinical professor in
orthopaedics at Albert Einstein College of Medicine in New York. He
is on the Editorial Review Board of the Journal of American Academy
of Orthopaedic Surgeons and the American Journal of Medicine and
Sports.
A graduate of Georgetown University School of Medicine, Dr. Plancher
received a master's degree in physiology and a medical degree cum
laude from the school of medicine. He did his residency at Harvard's
combined Orthopaedic program and a fellowship at the Steadman-Hawkins
clinic in Vail, Colo., where he studied shoulder and knee
reconstruction.
Dr. Plancher continued his relationship with the clinic for the next
six years as a consultant. He has been a team physician for over 15
athletic teams, including high school, college and national
championship teams. Dr. Plancher is an attending physician at Beth
Israel Hospital in New York City and The Stamford Hospital in
Stamford, and has offices in Manhattan and Greenwich. For more
information, visit Plancherortho.
http://www.acorn-
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StemCells subscribers may also be interested in these sites:
Children's Neurobiological Solutions
http://www.CNSfoundation.org/
Cord Blood Registry
http://www.CordBlood.com/at.cgi?a=150123
The CNS Healing Group
http://groups.yahoo.com/group/CNS_Healing
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