Bone Marrow Stimulation Techniques: Microfracture, Drilling, and Abrasion

Bone marrow stimulation techniques for the treatment of chondral defects include abrasion arthroplasty, debridement and drilling, and microfracture. The underlying premise of these techniques is that the body is capable of producing a repair tissue for a chondral defect if undifferentiated mesenchymal cells from the subchondral bone can be accessed. Proponents of these techniques advocate their technical simplicity, low patient morbidity, and cost-effectiveness. Critics argue that any clinical improvements obtained from these procedures are short lived and that the repair tissue generated is largely fibrous in nature with poor durability.