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 during the 1970s and 1980s. Arthroscopy surgical skills have been traditionally taught in cadaver labs, although the progression to in vivo operations varies from country to country. The International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) holds a list of approved courses for gaining surgical skills. A new teaching technique uses medical simulation as an alternative to cadaver training. High fidelity simulators range from those that use real surgical tools and passive haptics, such as VirtaMed's ArthroS™, to those that rely on active haptic feedback, such as the Arthro Mentor™ from Simbionix. When studied, passive haptics have