Microfracture is one of the most frequently used cartilage repair techniques. According to a comparative study performed at the Hospital for Special Surgery in collaboration with Cornell University, researchers found that smaller diameter instruments (Nanofracture®) showed the best prospects of accessing repair cells and were substantially less damaging to the underlying bone when compared to traditional microfracture or k-wire instruments.

The authors noted that bone marrow stimulation techniques using instruments with larger diameters resulted in increased bone compaction and sclerosis surrounding the defect. K-Wire and microfracture techniques resulted in less open communicating bone marrow channels denoting a reduction in marrow access. Larger diameter devices resulted in greater micro-architecture disturbances than the thinner nanofracture procedure. Based on these findings, the authors concluded that the choice of cartilage repair technique should be carefully considered.