Comparison of Magnetic Resonance Observation of Cartilage Repair Tissue Score and Functional Outcomes between Microdrilling and Microfracture for Cartilage Lesions of Distal Femur: A Retrospective Comparative Study

Abstract

Objective This study aimed to compare the clinical outcomes of microdrilling and microfracture for unipolar cartilage lesions of the distal femur.Design Patients who underwent either microfracture or microdrilling and had postoperative magnetic resonance imaging (MRI) at 1 year were retrospectively reviewed. The morphology of the repaired cartilage tissue was evaluated using Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 score. Functional outcomes were assessed using the International Knee Documentation Committee (IKDC) subjective, Lysholm scores, and Visual Analog Scale (VAS). In addition, the proportion of patients achieving improvement beyond the minimal clinically important difference (MCID) was analyzed.Results The MOCART score was significantly higher in the microdrilling group. Among the variables, volume fill of the cartilage defect and integration into the adjacent cartilage showed significantly better results in favor of the microdrilling group. A higher proportion of patients achieved improvement in the IKDC subjective score beyond the MCID in the microdrilling group, whereas no significant differences were observed between the groups in Lyholm score and VAS.Conclusion Microdrilling showed better outcomes in terms of the MOCART and IDKC subjective scores than microfracture, whereas Lysholm and VAS showed no significant differences. Further prospective studies are required to evaluate the results of these 2 procedures.