Marrow stimulation in football (soccer) players: a narrative review

• Main Authors: Zachary D. Meeker (Author), Nolan S. Horner (Author), Kyle R. Wagner (Author), Joshua T. Kaiser (Author), Armaan F. Mazra (Author), Brian J. Cole (Author)
• Format: Book
• Published: Elsevier, 2022-06-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2667-2545; 10.1016/j.jcjp.2022.100063
• Keywords: Microfracture; Football; Return-to-sport; Cartilage; Biologics; Restoration; Diseases of the musculoskeletal system; RC925-935; Other systems of medicine; RZ201-999; Sports medicine; RC1200-1245
• Source: Journal of Cartilage & Joint Preservation, Vol 2, Iss 2, Pp 100063- (2022)

Introduction: The prevalence of focal cartilage defects in elite athletes is estimated to be as high as 36%, and treatment in professional football players poses a complex clinical challenge. Marrow stimulation is a common treatment option for athletes with symptomatic, contained, full-thickness chondral injuries. Objectives: To report the current indications for and efficacy of marrow stimulation in football players. Methods: PubMed, Scopus, and Embase were searched. All levels of evidence (I-IV) pertaining to marrow stimulation in football players were analyzed and presented in a narrative review. Results: Reported return to sport rates following microfracture range from 52% to 95%, with up to 67% of athletes returning to preinjury level of performance. Clinical outcomes improve shortly after microfracture but may decline by 2 years postoperatively. Augmented marrow stimulation techniques have since been developed in an effort to improve repair quality and clinical outcomes, though supporting data is limited. Conclusion: In professional football players, marrow stimulation is a viable treatment for the repair of small (<2 cm2), isolated cartilage injuries, though deterioration of mid- to long-term outcomes may hamper its widespread use. Multiple augmentation techniques have demonstrated the potential to generate a mechanically and biologically superior repair; however, more robust, high-level studies are needed to adequately assess efficacy.