The Articular Cartilage Repair Second Look Biopsy Study
Microfracture and Articular Cartilage Paste Grafting are surgical repair techniques for full thickness articular cartilage lesions. Both rely on penetration of the subchondral bone to stimulate a healing response. Articular cartilage paste grafting goes further, by utilizing a paste made from the patient’s own bone, cartilage, and stem cells to enhance the healing response. Indications for microfracture and articular cartilage paste grafting are often similar. Surgeon preference, and often size and location of the lesion determine which repair technique is utilized.

Patients receiving microfracture or articular cartilage paste grafting to address arthritic lesions in their knees between 1993 and 2003 were brought back into surgery at an average of 18 months after their primary procedure to have biopsies taken of the early post-operative repair tissue. These tissue biopsies were then analyzed histologically and the quality of the repair tissue was reported based on 5 objective characteristics. All patients consented to long-term follow-up evaluation of their treated region by MRI and were asked to concurrently complete subjective outcomes evaluation forms.

Our current study seeks to compare quality of early repair tissue, current articular cartilage status as determined by MRI, and patient reported subjective outcome between microfracture and articular cartilage paste graft patients.

Why This Study Is Important
Microfracture is a very well studied procedure, and therefore comparison of this data will help to better describe the articular cartilage paste grafting procedure and the associated healing process. Additionally, by comparing long-term imaging to early post-operative repair tissue, we will establish baseline data for improvements to the articular cartilage paste graft protocol, including the appropriate dosing of growth factors. Future directions include adding growth factors to the paste graft and enhanced physical therapy rehabilitation.