Abstract

Microfracture (MF) treats small full-thickness cartilage defects in the knee by creating subchondral bone perforations to stimulate cartilage regeneration. Despite its popularity, MF produces fibrocartilage with inferior properties to native hyaline cartilage, leading to mid-term clinical deterioration. Microfracture plus (MFplus) aims to enhance outcomes by integrating scaffolds and orthobiologics. This scoping review evaluates MF and MFplus, focusing on clinical, MRI, and histological outcomes. Techniques examined include MF with porcine collagen membranes, HA-based matrices, and orthobiologics like PRP, BMAC, and ADMSC.

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