Microfracture Surgery

The Pheonix Suns have made Amare Stoudemire available and the Bulls are reportably one of the front runners to obtain the 26 year old power foward. The debate on Blogabull has been about contracts, players, potiental, and health.

When it comes to Stoudemire his microfracture surgery that was completed 3 years ago is always brought up. What is microfracture surgery? Who has under gone the surgery? What is the success rate? and what are the risk of re-injury?

Microfracture surgery is one of the articular cartilage repair surgical techniques that works by creating tiny fractures in the underlying bone. This causes new cartilage to develop from a so-called super-clot. Microfracture surgery has gained a profile in the sports world in recent years; numerous professional athletes including members of the NBA (most notably Greg Oden and Amar'e Stoudemire), NFL and NHL have undergone the procedure.

The surgery is performed by arthroscopy. After cleaning the calcified cartilage, the surgeon creates tiny fractures in the adjacent bones (through the use of an awl). 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 injury by the body, which is why the surgery results in new, replacement cartilage.The procedure is less effective in treating older patients, overweight patients, or a cartilage lesion larger than 2.5 cm.Further on, chances are high that after only 1 or 2 years of the surgery symptoms start to return as the fibrocartilage wears away, forcing the patient to reengage in articular cartilage repair. This is not always the case and microfracture surgery is therefore considered to be an intermediate step.

 Studies have shown that microfracture techniques don't fill in the chondral defect fully and the repair material they form is fibrocartilage. Fibrocartilage is not as good mechanically as the original hyaline cartilage; it is much denser and isn't able to withstand the demands of everyday activities as well as hyaline cartilage and is therefore at higher risk of breaking down.

There have been many notable professional athletes who have undergone the procedure. Partially because of the high level of stress placed on the knees by these athletes, the surgery is not a panacea and results have been mixed. Many players' careers effectively end despite the surgery. However, some players such as Jason Kidd, Steve Yzerman, John Stockton and Zach Randolph have been able to return at or near their pre-surgery form while players Brian Grant, Antonio McDyess, Chris Webber, Allan Houston and Penny Hardaway never regained their old form. Others such as Jamal Mashburn and Terrell Brandon never recovered and retired. Portland Trail Blazers rookie Greg Oden underwent the procedure in early September 2007 and missed the entire 2007-2008 NBA season. At only 19 at the time of the surgery, doctors are confident that he will return to at or near full strength by the 2008-2009 season.

In October 2005, young star Amare Stoudemire of the NBA's Phoenix Suns underwent one of the highest-profile microfracture surgeries to date. He returned to the court in March 2006 and initially appeared to have made a full recovery, but subsequently started feeling stiffness in both knees (his right knee had been overcompensating for the injured left knee). He and the team doctor decided he needed more time to rehab and he did not return until the 2006-2007 NBA season.During the 2006-2007 season, Stoudemire returned to form, averaging 20.4 points and 9.6 rebounds per game while playing in all 82 regular-season games and the 2007 NBA All-Star Game. His recent success has brought positive publicity to the procedure, further distancing it from a previous reputation as a possible "career death sentence" in the sports world, though he was one of the youngest of the aforementioned players to undergo the surgery.

Current studies have shown a success rate of 75 to 80 percent among patients 45 years of age or younger, even among professional athletes.

Kent YoungBlood list his version of the Good, The Not-So-Good, and The Ugly of NBA players who have undergone the surgery.  Amare Stoudemire is found under the Good. Other notables for the Good are Zach Randolph and John Stockton. Under the Not-So-Good we see players as Chris Weber and Jamal Mashburn. I would have placed Jamal Mashburn under The Ugly with players like Karl Malone and Terrell Brandon.

The one thing I couldn't find was the chances of re-injury. From what I have read it seems that if you follow your rehab and do not rush back to fast everything should be find.

Since Amare's Stoudemire is an on going case and he is one of the youngest players to have the surgery it is hard to tell what the long term effects will be. One thing is for sure is that Stoudemire has put in the work for his rehab.