Meet Our SurgeonLonnie D. Davis, MD

  • Dr. Davis is like no other...his compassion and kindness is superior! Easy to talk to, explains everything, open to all questions and takes time with you.

    Bonnie - Fairfax VA

  • He did an excellent job on my surgery and follow up. All was as expected. He answers questions thoroughly but does not waste patient time.

    Irene - Reston VA

  • Given the extent of my injury and accident, Dr. Davis did a miraculous job getting me back to normal. He always kept me informed of what to keep an eye on, and how to address certain aspects of my new life adjusting to this injury.

    Jake - Reston VA

  • He was very knowledgeable and excellent at translating what the issue with my knee was from medical terminology into layman's terms. He was extremely thorough and with this being my third opinion on my knee, I immediately decided I would continue through the surgery process with Dr. Davis.

    Eva - Washington DC

  • He is fantastic! Very kind. Smart. Answered my questions. I know nothing. And he was so patient. Treated my son with wonderful kindness and dignity. Dr. Davis is a good man. Glad to have met him! Will definitely go to his office in the future if we have a need for it.

    Jodi - Reston VA

  • It was my first appointment with Dr. Davis and he impressed me with his concern for my wellbeing. He is extremely thorough, spends plenty of time with you and has an excellent bedside manner. I would recommend him to anyone with a sports related injury.

    Lauren - Alexandria VA

  • I'm pretty active and have seen Dr. Lonnie Davis for a number of sports-related injuries for the past few years. I've seen him for a torn ACL, stress fracture in the foot, rock-climbing hand and ankle injuries, etc. I was really impressed with how well my ACL surgery, care and recovery went. He's been great at diagnosing the problems and getting me back to sports.

    Jennie - Annandale VA

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Lonnie D Davis MD

Micro Fracture

Microfracture is a surgical technique used to repair articular cartilage damage in the knee called chondral defects. Articular cartilage is a complex avascular (no blood supply) tissue which consists of cells called chondrocytes suspended in a collagenous matrix. It appears as a smooth, shiny, white tissue at the ends of the bones which come in contact with each other to form a joint. It reduces friction when the bones glide over each other and makes the movements smooth. Alternately, it acts as a shock-absorber and enables the joint to withstand weight. Articular cartilage is subjected to normal wear and tear from daily activities and when damaged due to injury it causes pain and impaired function. Because it has no blood supply, it is unable to repair itself and can progress to arthritis. As a result, several surgical methods have been devised to restore articular cartilage and help prevent progression to arthritis.

Indications and Contraindications

Microfracture is a common surgical technique used to repair damaged knee cartilage by drilling small holes into the knee joint to stimulate new cartilage growth.

The best candidates for Microfracture include:

  • Patients whose cartilage degeneration is limited to small areas in the knee
  • Younger patients who are very active and wish to return to their sport or activity
  • Patients with pain in the knee from cartilage injuries

Microfracture is not recommended for patients who have widespread arthritis of the knee, are inactive, and those are unwilling or unable to participate in a rehabilitation program after the procedure.

Diagnosis

Your doctor will perform a physical examination to look for altered range of motion, swelling, and alignment of the bones. As cartilage is uncalcified it does not show up on X-rays. A high-quality MRI is often required and arthroscopy is used as the final determination to what technique may be best.

Procedure

The procedure is performed under local anesthetic (numbing at the site), spinal anesthetic, or general anesthetic. Microfracture can be performed using an arthroscope, a narrow tube with a tiny camera on the end to visualize the inside of your joint. Your surgeon will make a ΒΌ inch incision on your knee. An arthroscope is inserted through this incision. The camera attached to the arthroscope displays the image of the joint on the monitor. A sterile solution will be pumped into your knee in order to stretch the knee and provide a clear view and room to work. Another incision is made through which specially designed instruments are inserted.

Your surgeon prepares the area by removing any damaged cartilage. Multiple tiny holes called microfractures are then made into the subchondral bone (below the cartilage) with a sharp tool called an awl. This helps to bring blood supply from the deeper more vascular bone to the surface tissues. This technique creates a nourishing environment for tissue regeneration by using the body’s natural healing abilities to form new cartilage.

Post-operative Care

Following microfracture, your doctor will recommend physical therapy to help restore motion of the operative joint. Immediately after the surgery, most patients can begin physical therapy with a continuous passive motion machine or CPM. The CPM is used to gently exercise your operated leg for 6 to 8 hours per day for several weeks. You will be instructed on using crutches to avoid weight bearing activities for a few days. You will be allowed to return to sports or other intense activities 4 months after surgery.

Risks

As with any surgery, risks are involved. Risks associated with microfracture surgery include:

  • Bleeding
  • Infection
  • Breakdown of the newly formed cartilage may occur
  • Increased stiffness of the knee joint

Useful Links

  • The American Academy of Orthopaedic Surgeons
  • Medical Society of Virginia
  • American Orthopaedic Society for Sports Medicine
  • American Board of Orthopaedic Surgery
  • mid atlantic shoulder elbow society
  • mclean high school
  • STOP Sports Injuries