1. UK Knee microfracture experience

Dear Colleague,

We are conducting a study to investigate the practice of microfracture for chondral defects in the knee. We would like to determine how many surgeons perform microfracture, and we wish to explore variations in the indications for surgery. More specifically we would also like to see if there are any difference in how the technique is performed and what rehabilitation patients receive after surgery. We are comparing practice in the UK to practice in Canada.
In order for us to achieve this goal, we kindly seek your assistance by way of completing a short survey.
Many thanks for participating in this study; your cooperation is greatly appreciated.

Mr Rik Kundra
Mr Pankaj Sharma
Dr John Theodoropoulos
Dr Daniel Whelan
Dr Paul Marks
Dr Mark Hurtig

University of Toronto, Department of Sports Medicine

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1. What are your main areas of practice?

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2. In which year did you commence your orthopaedic practice?

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3. Have you completed a sports medicine fellowship?

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4. Do you perform microfracture for chondral defects of the knee?

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5. Do you have any age limit for performing microfracture?

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6. Do you have any upper limit for BMI to perform microfracture?

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7. If you have an upper limit for BMI in performing microfracture, what is it?

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8. Do you use any preoperative scoring systems?

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9. Is your decision to microfracture influenced by the score?

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10. Would you perform microfracture in an ACL deficient knee?

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11. Would you consider revision microfracture?

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12. Which of the following defects would you be happy to microfracture?

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13. Are you happy to perform microfracture on multiple defects?

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14. Do you resect cartilage back to a stable margin prior to microfracture?

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15. Do you remove the calcified cartilage layer prior to microfracture?

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16. What instrument do you use to perform to microfracture?

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17. What type of mallet do you use?

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18. Are you confident you can create microfracture holes 3 - 4 mm apart?

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19. Do you make the holes deeper for any of the following reasons?

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20. Do you make the holes closer for any of the following reasons?

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21. Do you find that microfracture picks tend to slip resulting in holes merging with one another?

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22. Do you visualise fat droplets in the joint to ensure marrow cavity penetration?

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23. Do you routinely inject local anaesthetic after knee microfracture?

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24. Do you wash out the joint after performing microfracture?

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25. After microfracture do you use CPM?

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26. If you use CPM, how many hours a day do you recommend?

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27. If you use CPM, how many weeks use do you recommend?

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28. What weight bearing status do you advocate following microfracture?

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29. For how many weeks do patients follow altered weight bearing?

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30. If you use any scoring system to assess response to microfracture, please state which ones?

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31. Do you use any imaging to assess response to microfracture?

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32. What is your overall impression of the success rate of this technique?

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33. How long do you think the benefit from microfracture lasts?

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34. Do you feel any of the following techniques offer advantages over microfracture?

T