Prior Microfracture Impairs Clinical Improvement After Knee Replacement Surgery

Patients receiving total knee arthroplasty (TKA) who underwent previous microfracture (MFX) surgery experience slightly less clinical improvement versus patients without a previous MFX, according to a recent study.

MFX surgery is commonly used to treat articular cartilage lesions. However, little information exists regarding outcomes in patients who underwent total knee arthroplasty (TKA) after previous MFX.
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The researchers retrospectively evaluated 21 patients with prior MFX surgery who received TKA between 2005 and 2014. Patients were matched 2:1 with 42 patients who did not undergo previous MFX.

Additionally, the researchers calculated Subjective Knee Society (KSS) Score (KSS-S), KSS Function (KSS-F), as well as any complications.

Results of the study showed that patients in the MFX group demonstrated significantly less improvement in both KSS-S and KSS-F scores versus those in the control group. At 5 years, the failure rate was 4.8% in the MFX group compared with 2.4% in the control group.

Older age at TKA resulted in smaller improvement in KSS-S, according to multivariate analysis. Patients who were older and had decreased range of motion prior to surgery had worse KSS-S scores, as did women with a higher body mass index (BMI).

“Survivorship was similar between groups, but patients with MFX had slightly less clinical improvement compared with a matched control group,” the researchers concluded. “This study suggests that underlying patient factors may limit clinical improvement compared with primary TKA.”

—Christina Vogt

Reference:

Ansari MH, Pareek A, Johnson NR, Abdel MP, Stuart MJ, Krych AJ. Clinical outcome of total knee arthroplasty after prior microfracture: a matched cohort study. 2017;40(30):e473-e478. doi:10.3928/01477447-20170223-02.