# Can surgery repair cartilage, the smooth cover over shoulder bone? *Microfracture Surgery — Shoulder Regeneration Surprise AZ* > Microfracture surgery explained plainly: what it fills, how broad cartilage wear differs, and what to ask before an operation. A deep shoulder ache can make surgery sound like the next step. Cartilage is the smooth cover over each bone end. One small damaged spot differs from wear across the whole joint. ## Which cartilage damage can an operation fill? A small hole in cartilage has firm edges that an operation may fill with repair tissue. The repair tissue covers bone, but it isn't original cartilage. It may also wear sooner than the old smooth cover. Broad wear leaves much of the ball or socket rough. Years of use may roughen a wide area instead of leaving one neat hole. Shoulder cartilage repair only makes sense when the damaged area matches the operation. ## How does microfracture surgery cover a small hole? During microfracture surgery, a surgeon makes tiny holes directly beneath the bare cartilage spot. Marrow, the soft material inside bone, can then seep through them. The marrow forms a clot over the bare area. That clot slowly becomes a rougher type of repair cover. It isn't the same as the joint's first smooth cartilage. The new cover needs time to form and strengthen. Microfracture is meant for one defined hole, not broad shoulder wear. ## What should an X-ray or MRI show before surgery? Ask whether the damage is one hole or wear across the joint. An X-ray shows bone, while an MRI scan shows cartilage and nearby tendons. Ask the surgeon to point out the damaged spot on both kinds of pictures. Next, ask what the operation is expected to change for you. It may aim to reduce soreness, improve use, or cover bare bone. Those are different goals, and none promises a new joint. Your strength, daily needs, and recovery time also affect the choice. ## Sources 1. A concise review of mesenchymal stem cells for functional cartilage tissue engineering sets out the underlying problem: articular cartilage is avascular and has very limited intrinsic repair capacity, which is precisely why engineered and cell-based approaches are being pursued - and why building tissue that matches native articular cartilage in composition and mechanical function remains an unsolved engineering problem rather than a delivered clinical product. Tan AR, et al. — [Concise Review: Mesenchymal Stem Cells for Functional Cartilage Tissue Engineering: Taking Cues from Chondrocyte-Based Constructs.](https://pubmed.ncbi.nlm.nih.gov/28177194/). *Stem cells translational medicine*, 2017. DOI: 10.1002/sctm.16-0271. 2. MACI (autologous cultured chondrocytes on a porcine collagen membrane, Vericel; STN BL 125603) IS an FDA-LICENSED cell therapy - and its approved indication is narrow and specific: repair of symptomatic, single or multiple FULL-THICKNESS cartilage defects OF THE KNEE, with or without bone involvement, in adults. It is not approved for osteoarthritis. The existence of one licensed cartilage cell therapy for focal defects is the sharpest available way to show what a licensed 'regeneration' product actually looks like, and how far it is from an injection for a worn joint. US Food and Drug Administration, Center for Biologics Evaluation and Research — [MACI (autologous cultured chondrocytes on porcine collagen membrane)](https://www.fda.gov/vaccines-blood-biologics/cellular-gene-therapy-products/maci-autologous-cultured-chondrocytes-porcine-collagen-membrane). *FDA*, 2024. 3. The SUMMIT randomized trial treated 144 patients (mean age 33.8, mean lesion 4.8 cm2) with at least one symptomatic focal cartilage defect (Outerbridge III/IV, >=3 cm2) of the femoral condyle or trochlea. Matrix-applied characterized autologous cultured chondrocytes (MACI) improved KOOS pain (37.0 to 82.5) and function significantly more than microfracture (pain 35.5 to 70.9) at 2 years, with histological and MRI assessment of the repair tissue. This is what a positive cartilage-repair trial looks like - in young patients with a discrete hole, not a worn joint. Saris D, et al. — [Matrix-Applied Characterized Autologous Cultured Chondrocytes Versus Microfracture: Two-Year Follow-up of a Prospective Randomized Trial.](https://pubmed.ncbi.nlm.nih.gov/24714783/). *The American journal of sports medicine*, 2014. DOI: 10.1177/0363546514528093. 4. Eighty patients with a single symptomatic chronic femoral condyle cartilage defect were randomized to autologous chondrocyte implantation or microfracture and followed 14-15 years. No significant difference in clinical scores emerged at long-term follow-up; there were 17 failures in the ACI group versus 13 in the microfracture group and more total knee replacements after ACI (6 versus 3). Fifty-seven percent of surviving ACI patients and 48% of surviving microfracture patients had radiographic early osteoarthritis (KL >=2). Knutsen G, et al. — [A Randomized Multicenter Trial Comparing Autologous Chondrocyte Implantation with Microfracture: Long-Term Follow-up at 14 to 15 Years.](https://pubmed.ncbi.nlm.nih.gov/27535435/). *The Journal of bone and joint surgery. American volume*, 2016. DOI: 10.2106/JBJS.15.01208. 5. FDA's public list of licensed cellular and gene therapy products is the checkable answer to 'is this FDA-approved?'. A product not on that list, and not being administered under an active IND, is not an approved therapy however it is described in a brochure. For orthopedics the list is short and its cartilage entry is MACI, indicated for focal full-thickness knee defects. US Food and Drug Administration, Center for Biologics Evaluation and Research — [Approved Cellular and Gene Therapy Products](https://www.fda.gov/vaccines-blood-biologics/cellular-gene-therapy-products/approved-cellular-and-gene-therapy-products). *FDA*, 2026. ## Could a shoulder exam identify what is sore? A hands-on exam checks strength, motion, and tender spots. Bring any MRI report and notes about earlier care so the doctor can explain your choices. Book a free consultation: --- Surprise, Arizona Learn what may cause a sore shoulder, which relief steps can help, and when to arrange an exam. Clear information about shoulder soreness, relief choices, and nearby care in Surprise. The Repair Line is operated by the owners of the QC Kinetix Phoenix-area clinics (the franchisee behind the Peoria, Banner Estrella, Chandler and Scottsdale locations), so read every mention of that clinic on this site as exactly what it is: a publisher naming its own business. © 2026 The Repair Line, Surprise, Arizona. Published by the owners of the QC Kinetix Phoenix-area clinics.