Microfracture surgery is an articular cartilage repair technique performed by creating small fractures in the underlying bone in order for new fibrocartilage to form. Arthrex provides products, including the PowerPick, allowing surgeons to effectively perform microfracture surgery safely and reproducibly.

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Knee Next Generation in Repair and Reconstruction

Imaging and Resection

Thomas M. DeBerardino, MD, (San Antonio, TX) chooses the PowerPick™ device for all lesions prior to placing BioCartilage® matrix to enhance healing. Dr. DeBerardino prefers the PowerPick device because of the quick and repeatable one-handed process. He also shares that the PowerPick device reduces skiving as opposed to the typical dull, reusable pick that requires assistance with a mallet.

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Articular Cartilage Preparation Using the PowerPick™ Instrument

So here we have a prepared medial femoral condyle cartilage using clearly grade four. Here's our Arthrex PowerPick. It's the curved or angled one. It comes in two different formats. You can see the curvature there as I bring it into the notch. The PowerPick comes in non-deployed. And then there's a plastic handle that you pull toward the shaver with one of your hands as the surgeon deploys the drill. I like to deploy it before I turn the drill on to make sure everything is working good. And I know how far in this knee, how much room I have between condyle and sheath. So then you go only in the forward direction in my hands. And here we're going to start just like we would in a standard microfracture technique. We're going to come up visually with a pattern. I work in the periphery first here, here, here, here and here. And then we'll do 2 or 3 in this smaller lesion. So we'll do the periphery first. And I'll use two hands to do this one to steady at the skin or the portal and go in flush. Pull straight out. Move over. Go in till I'm flush. Pull out. Go over in the other corner in flush. Pull out. Then we'll take a shaver and you can see it looks like honeycomb. And right now we're looking right at it. That looks pretty good, but a shaver. What a shaver does is just cleans out the orifices of the different poke holes or drill holes. And I'll turn it on. Just oscillating. Just a little light suction. You can turn down your pump at this time. Now you see the final nice honeycomb pattern. Sometimes I'll just pat the leg. And because I don't do a tourniquet that actually shakes the marrow elements literally out of the holes. And now after this would either open or arthroscopically put our BioCartilage over this lesion, because I never in the past three years do just a microfracture alone. We like to biologically augment it and do a super microfracture or BioCartilage application over this. So there's a good use of the PowerPick to have a controlled microfracture picking of a medial femoral condyle. Grade four lesion.

Orthobiologics

The OrthoIllustrated® animation for bone marrow stimulation - knee microdrilling is an educational tool to help patients better understand this procedure.

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Microfracture with PowerPick™ Device

The surgeon begins by creating two portals or small incisions in the front of the knee. The arthroscope is inserted through one portal and a passport cannula is inserted through the other. The articular cartilage injury in the knee is identified and probed. An arthroscopic shaver or burr is placed inside the knee through the cannula. The area of diseased cartilage is smoothed with a shaver down to subchondral bone. A rim of stable cartilage is created around the lesion, and a chondral pick is inserted into the knee. The pick is used to punch small holes in the bone where the lesion is located. These holes allow blood from inside the bone to cover the defect. The blood forms a clot over the area of injured articular cartilage, and this clot is slowly converted to a different form of cartilage covering the defect.

Spanish (Español) - es

Reparación de cartílago por microfractura

El cirujano comienza creando dos portales o pequeñas incisiones en la parte delantera de la rodilla. Se inserta el artroscopio por uno de los portales y por el otro se inserta una cánula. Passport se identifica y se explora la lesión cartilaginosa de la rodilla a través de la cánula se inserta en la rodilla. Una afeitadora artroscópica. El área de cartílago enfermo se alisa con la afeitadora hasta llegar al hueso subcondral. Se crea un anillo de cartílago estable alrededor de la lesión y se inserta un punzón condral en la rodilla. Este punzón se utiliza para hacer pequeños orificios en el hueso en el lugar donde se encuentra la lesión. Estos orificios permiten que la sangre del interior del hueso cubra el área defectuosa. La sangre forma un coágulo sobre el área de cartílago lesionado y este coágulo se convierte lentamente en un tipo diferente de cartílago que cubre la lesión.

German (Deutsch) - de

Rekonstruktionen von Knorpeldefekten - Mikrofrakturierung

Zunächst setzt der Operateur zwei kleine Hautschnitte an der Vorderseite des Knies. Durch einen wird das Arthroskope eingeführt, durch den anderen eine Passport Kanüle eingesetzt. Die Beschädigung des Gelenkknorpels im Knie wird dargestellt und es wird eine Gewebeprobe entnommen. Durch die Kanüle wird ein arthroskopischer Viewer, eine Fräse in das Knie eingeführt. Der geschädigte Knorpel wird mit dem Schefer bis zum darunterliegenden Knochen geglättet. Um die Schädigung wird eine stabile Knorpelkante geschaffen. Dann wird ein Bohrer für die MikroFrakturierung in das Knie eingeführt. Mit diesem werden kleine Löcher im Bereich der Schädigung gebohrt. Durch diese Löcher kann Blut aus dem Knochen austreten und den Defekt bedecken. Das Blut bildet ein Gerinnsel über dem geschädigten Gelenkknorpel, das in den Wochen nach der Operation in eine andere Knorpelform umgewandelt wird und schließlich den Knorpeldefekt bedeckt.

French (Français) - fr

Réparation du cartilage par la technique de microfracture

Le chirurgien commence par ouvrir deux accès, des petites incisions sur le devant du genou. Il introduit l'arthroscopie par l'une des incisions et une canule passeport par l'autre. Il localise et évalue la lésion du cartilage articulaire du genou. Un chercheur arthroscopique ou fraise introduit dans le genou par la canule permet de lisser la zone cartilagineuse malade jusqu'à l'os Sous-chondral. Le chirurgien crée alors une bordure de cartilage stable autour de la lésion et introduit dans le genou un pointeau pour faire des petits trous dans l'os à l'endroit de la lésion. Ces trous permettent au sang de sortir de l'os pour recouvrir le defect et de former un caillot sur toute la surface du cartilage articulaire endommagé. Ce caillot se transformera lentement en une forme différente de cartilage recouvrant le defect.

Dutch (Nederlands) - nl

Reconstructie van kraakbeen met microfracturing

Eerst maakt de chirurg twee openingen of kleine incisies aan de voorkant van de knie. Door de ene opening wordt de arthroscopie naar binnen geleid, door de andere een paspoort canule. De schade aan het gewricht kraakbeen in de knie wordt onderzocht. Door de canule wordt een shaver of frees in de knie ingebracht. De plaats van het beschadigde kraakbeen wordt met de shaver tot op het onderliggende bot glad gemaakt. Rond de beschadiging wordt een stabiele kraakbeen rand gemaakt. Dan wordt een John dropkick in de knie gebracht. Hiermee worden kleine gaatjes in het gebied van de beschadiging gemaakt. Door deze gaatjes kan er bloed uit het bot stromen en de beschadiging bedekken. Het bloed stolt rond het beschadigde gewricht kraakbeen en dit stolsel verandert langzaam in een andere kraakbeen vorm en bedekt het beschadigde kraakbeen.

APS II Footswitch, Multifunction, Corded

Multifunktions- Fußschalter für Adapteur Power System II, mit Kabel

Footswitch for Adapteur Power System II, Multifunction, Corded

Pedal para Adapteur Power System II, multifuncional, concable

Shaver HP, APS II, Footswitch Control

Shaverhandstück Adapteur Power System II, mit Fußsteuerung

Shaver Handpiece Adapteur Power System II, Footswitch Control

Pieza de mano Adapteur Power System II, controlada porpedal

PECA DE MAO DE SHAVER COM CONTROLE NO PEDAL

Microfracture

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Catalogs (1)

Knee Next Generation in Repair and Reconstruction

Patient Education Animations (5)

Microfracture with PowerPick™ Device

Reparación de cartílago por microfractura

Rekonstruktionen von Knorpeldefekten - Mikrofrakturierung

Réparation du cartilage par la technique de microfracture

Reconstructie van kraakbeen met microfracturing

Product Demonstrations (1)

Articular Cartilage Preparation Using the PowerPick™ Instrument

Related Products (4)

AR-8150PX-45

AR-8150PP-45

AR-8150PP-30

AR-1760S

Accessories (2)

AR-8315C

AR-8330F