Kevin Plancher, M.D. a leading New York Orthopaedic Surgeon, has a national reputation for his expertise in performing the Microfracture procedure on patients with arthritic knees with worn away cartilage. The Microfracture procedure is spurred to generate its own new cartilage like surface, (the white fibrous cushion that keeps bone from rubbing against bone in joints), and it is far less invasive, simpler and easier on the patient than other treatments for bad knees.

?While the patient is under regional anesthetic, an epidural or spinal, we arthoscopically use a special ice pick-like tool to punch tiny little holes in the bone near the place where cartilage is gone,? said Dr. Plancher. ?This forms healing cells and releases cells that have the potential to become new cartilage and releases growth factors that are in the marrow.?

?It's the same principle that's behind the healing of a broken bone,? Dr. Plancher added. ?The body has the natural elements to help the bone fix itself, and the surgeon is just helping it heal straight. In Microfracture, the surgeon purposely helps begin the healing process, with the goal of stimulating the body into making new cartilage.?

In a majority of patients that undergo Microfracture, it's enough to permit them to return to an activity level that's acceptable to them.

In a study of 300 patients that have had the surgery for at least five years, only about 20% didn't show any improvement in the knee function. Twelve patients went on to other procedures, like the more complicated joint replacement. Seventy to seventy-five percent found significant healing of what is called the ?cartilaginous surface,? and were able to return to active lives.

?The procedure's success means that, in most patients, the need for partial or total metal and plastic replacements of the knee can be delayed,' according to Dr. Plancher. ?Microfracture may be the initial procedure of choice for early arthritis of the knee.?

Microfracture may hold promise for other injured joints, like the hip or ankle, but at his time there are no follow-up studies on those procedures. The knee is still the best candidate for the procedure, partly because it is the most common arthritic joint.