Microfracture surgery due to a lack of studies on the long-term effects and the fact that an unsuccessful surgery could end an athlete's career. Dr. Steadman has also adapted the surgery into a treatment to help reattach torn ligaments (a technique he calls the "healing response") The surgery is performed by arthroscopy, after the joint is cleaned of calcified cartilage. Through use of an awl, the surgeon creates tiny fractures in the subchondral bone plate. Blood and bone marrow (which contains stem cells) seep out of the fractures, creating a blood clot that releases cartilage-building cells. The microfractures are treated as an
Arthroscopy might be performed in order to visually check other parts of the knee and to insert the miniature instruments that are used to perform surgical procedures. The BMJ Rapid Recommendations group makes a strong recommendation against arthroscopy for osteoarthritis on the basis that there is high quality evidence that there is no lasting benefit and less than 15% of people have a small short-term benefit. There are rare but serious adverse effects that can occur, including venous thromboembolism, infections, and nerve damage The BMJ Rapid Recommendation includes infographics and shared decision making tools to facilitate a conversation between doctors and