ReviewAnnals of joint2025
Detriment of subchondral plate violation in antegrade osteochondral procedures-lessons and future direction.
Review in Annals of joint, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The microfracture procedure, introduced in 1994 by Dr. Steadman, involves creating small perforations in the subchondral bone plate to stimulate cartilage regeneration through fibrocartilage formation. Early studies demonstrated its efficacy in improving patient-reported outcomes for small osteochondral defects, particularly in young, active patients. However, its popularity has declined due to poor long-term outcomes and limited indications. Emerging alternatives, such as autologous chondrocyte implantation (ACI) and osteochondral allograft/autograft transplantation (OAT), show superior long-term results. Antegrade procedures like microfracture and drilling aim to release marrow elements to facilitate cartilage repair, but evidence for their efficacy is limited. These techniques can damage subchondral structures, triggering inflammatory and mechanical changes, including subchondral cysts, osteophytes, and reduced bone mineral density. Retrograde drilling, which avoids subchondral plate violation, emerges as a potential solution, promoting revascularization while preserving structural integrity. Despite promising results in subchondral fracture fixation and avascular necrosis, clinical studies are needed to confirm its efficacy for cartilage repair. The key challenge lies in balancing sufficient marrow stimulation with subchondral plate preservation to maintain long-term joint functionality. Future research should focus on understanding the interplay between subchondral plate integrity and cartilage repair durability. Comparative clinical trials are essential to validate retrograde drilling and other evolving techniques as viable alternatives to traditional microfracture and drilling procedures.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.