Knee · Cartilage
Subchondral fracture fixation
Subchondral Insufficiency Fracture of the Knee (SIFK)
The condition
A subchondral insufficiency fracture is a small crack in the bone just beneath the knee's cartilage, caused by everyday stress on overloaded bone. It can occur spontaneously or follow a meniscus tear and shows as bone swelling on MRI. It causes deep knee pain with standing and walking that can last for months.
The surgery
Through small incisions (typically outpatient), a small implant is placed across the fracture under x-ray guidance to support the bone as it heals; the joint may also be checked with a camera. If a torn meniscus or root is repaired at the same time, your recovery will change. The final plan is determined during surgery.
Recovery at a glance
- Weight-bearing
- Full weight as tolerated with crutches for ~2 weeks, then weaned as pain allows. No brace or motion limits.
- Daily life
- Desk work often within 1 week. Stationary bike and strengthening start early. No driving while taking narcotic pain medication.
- Impact
- No running or jumping for at least 12 weeks; an MRI may be checked at ~3 months.
- Sports
- Jumping, running, and drills progress between 3 and 6 months. Full return typically 5–6 months, after a follow-up MRI.
A general guide. Your restrictions and timeline may change based on what is found and done at surgery.
Risks & benefits
Benefits: Most patients have less pain and return to walking and their activities. Risks are uncommon and include infection, blood clots, ongoing pain or collapse of the bone surface (which may need more surgery, including knee replacement), irritation from the implant, injury to nearby structures (such as nerves, blood vessels, or cartilage), stiffness, persistent pain, and the need for further surgery. These will be reviewed with you in detail before surgery.
Patient Surgical Information
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Before & after every surgery