The surgery is quick (typically lasting between 30 and 90 minutes), minimally invasive, and can have a significantly shorter recovery time than an arthroplasty (knee replacement).

[1] However, acute traumatic osteochondral lesions or surgically created lesions extending into subchondral bone, e.g. by Pridie drilling,[2] spongialization[3] abrasion[4] or microfracture causing the release of multipotent mesenchymal stem cells from the bone marrow, may heal with repair tissue consisting of fibrous tissue, fibrocartilage or hyaline-like cartilage.

[11] Further on, chances are high that after only 1 or 2 years of the surgery symptoms start to return as the fibrocartilage wears away, forcing the patient to reengage in articular cartilage repair.

A couple of physicians are promoting an alternative treatment implanting autologous mesenchymal stem cells directly into the cartilage defect, without having to penetrate the subchondral bone.

In terms of time, the clot takes about 8 to 15 weeks for conversion to fibrous tissue and is usually fibrocartilage by about four months post surgery, holding implications for the rehabilitation.

In February 2008, Saris et al. published a large-scale study claiming that CCI results in better structural repair for symptomatic cartilage defects of the knee than microfracture surgery.

[citation needed] Portland Trail Blazers rookie Greg Oden underwent the procedure on his right knee in early September 2007 and missed the entire 2007–2008 NBA season.

[17] The former San Antonio Spurs and Houston Rockets player, Tracy McGrady also underwent microfracture surgery; doctors were confident that the two-time scoring champion would return to full strength.

His success brought positive publicity to the procedure, further distancing it from a previous reputation as a possible "career death sentence" in the sports world, though he was one of the youngest of the aforementioned players to undergo the surgery.

[19] In June 2010, Grady Sizemore of the Cleveland Indians underwent microfracture surgery after injuring his left knee while diving back to first base earlier in the season.

The patients are encouraged to spend approximately 6–8 hours a day on a CPM (continuous passive motion) machine that helps with optimal re-growth of joint surface.

[citation needed] Steadman cites the significance of a patient's natural joint alignment in addition to disciplined rehabilitation in recovery from the procedure.