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J Knee Surg 2022; 35(07): 707-717
DOI: 10.1055/s-0040-1716552
Original Article

Microfracture versus Enhanced Microfracture Techniques in Knee Cartilage Restoration: A Systematic Review and Meta-Analysis

Authors

  • Hong-Jie Wen

    1   Department of Orthopaedic Surgery, The Fourth Affiliated Hospital of Kunming Medical University, Kunming, China

  • Li-Bo Yuan

    2   Department of Orthopaedic Surgery, 920th Hospital of Joint Logistics Support Force, Kunming Medical University, Kunming, China

  • Hong-Bo Tan   ∗

    2   Department of Orthopaedic Surgery, 920th Hospital of Joint Logistics Support Force, Kunming Medical University, Kunming, China

  • Yong-Qing Xu   ∗

    2   Department of Orthopaedic Surgery, 920th Hospital of Joint Logistics Support Force, Kunming Medical University, Kunming, China

Funding This study was supported by the National Natural Science Foundation of China (H0607) and the National Key Research and Development Program of China (grant number: 2017YFC1103904).
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Abstract

This study aimed to compare the efficacy and safety of the microfracture (MFx) and microfracture augmented (MFx + ) techniques for the treatment of cartilage defects of the knee. The PubMed and EMBASE databases were searched from 1 January, 1950 to 1 May, 2019. RevMan5.3 was used to perform statistical analysis. Relative risk was calculated for binary variables, and weighted mean difference and standardized mean difference (SMD) were measured for continuous variables. The 95% confidence interval (CI) of each variable was assessed. Thirteen trials with 635 patients were included. There was a significant difference in the Lysholm's score (SMD = 0.26, 95% CI: 0.01–0.50, p = 0.04) and magnetic resonance observation of cartilage repair tissue score (SMD = 14.01, 95% CI: 8.01–20.02, p < 0.01) between the MFx and MFx+ groups. There was no significant difference in the Western Ontario and McMaster Universities Osteoarthritis Index score (SMD =  − 12.40, 95% CI: −27.50 to 32.71, p = 0.11), International Knee Documentation Committee score (SMD = 8.67, 95% CI: −0.92 to 18.27, p = 0.08), visual analog scale score (SMD =  − 0.20, 95% CI: −2.45 to 0.96, p = 0.57), Tegner's score (SMD = 0.26, 95% CI: −0.67 to 1.18, p = 0.59), modified Cincinnati's score (SMD =  − 4.58, 95% CI: −14.31 to 5.14, p = 0.36) and modified International Cartilage Repair Society pain score (SMD = 0.09, 95% CI: −0.37 to 0.55, p = 0.70) between the groups. Results of the pooled analyses of the MFx+ and MFx groups suggested that the MFx+ technique is slightly superior to the MFx technique for the treatment of articular cartilage defects of the knee. Further research is required and future studies should include assessments of the outcomes at long-term follow-ups. Trial registration number is PROSPERO CRD42019135803.

Keywords

microfracture - enhanced microfracture techniques - knee cartilage restoration - meta-analysis

Note

All data generated or analyzed during this study are included in this published article.


Authors' Contributions

H.J.W. participated in the conception and design of this study. H.J.W., L.B.Y., and H.B.T. performed the acquisition of data. L.B.Y. and H.J.W. performed the statistical analyses. H.B.T. was involved in the interpretation of data. H.J.W. drafted the manuscript. Y.Q.X. and H.B.T. revised the manuscript for important intellectual content. All authors have read and approved the manuscript.


∗ Hong-Bo Tan and Yong-Qing Xu are co-corresponding authors.


Supplementary Material



Publication History

Received: 06 January 2020

Accepted: 29 July 2020

Article published online:
20 September 2020

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