Date of Graduation

8-15-2009

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Mark Pedemonte, MD

Second Advisor

Rob Rosenow PharmD, OD

Third Advisor

Annjanette Sommers MS, PA-C

Abstract

INTRODUCTION: Sports injuries can often result in full thickness chondral lesions. If left untreated, these injuries can lead to localized pain, inflammation, effusion and further cartilage injury. Such injuries in an athlete can be career ending. The current recommendation for treatment is microfracture. Many studies have evaluated this technique in the general population, but only minimal attention has been given specifically to athletes.

METHODS: The focus of this study was to review the current literature for the last ten years on all studies pertaining to treatment of athletes who suffered full thickness chondral injuries and were treated with microfracture. The majority of studies reviewed evaluated microfracture without comparison against other modalities. Only one study compared microfracture with autologous osteochondral transplantation (OAT).

RESULTS: Of the five studies that were evaluated in this review, all showed improvement in functional ability and a decrease in pain post microfracture surgery. The ability of the athlete to return to their sport at a pre-injury level showed variability among the studies.

CONCLUSION: Microfracture is an effective technique in the management of full thickness chondral injuries, however given the results of microfracture in comparison to OAT, it may not be the best option. Further studies, including more comparison trials will help to establish the best treatment modalities for both immediate and long term management.

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