NanoFx system offers a “smaller, deeper, better” solution

Nanofracture (NanoFx®) is a new treatment approach to mesenchymal stem cell stimulation. This new approach to microfracture provides several advantages when compared to standard bone marrow stimulation procedure.

It becomes a better option where bone marrow stimulation procedures are used to improve the tissue repair response, for example cartilage lesions or rotator cuff tears. NanoFx gives significantly better results3,4.


The smaller diameter causes less trauma to the subchondral bone surface and may provide a greater perforation density compared to the much larger 2,5 mm microfracture awl when the reported bone bridge distance of two to four millimeter is maintained1.


Drilling deeper to 6 mm versus 2 mm improved repair tissue quantity and quality in a statistically significant fashion, while drilling compared to microfracture at the same 2 mm depth produced similar repair outcomes. Improvement in tissue repair due to deep versus shallow drilling was significant2.


Chondral repair assessed after 12 months revealed that nanofracture provided better repair tissue than microfracture, with a better cartilage architecture and tissue having greater type II collagen content3.

closed trabecular channels, microCT comparison: Axial (top) Sagittal (bottom)

open trabecular channels

  1. Benthien et al. Reviewing subchondral cartilage surgery: considerations for standardised and outcome predictable cartilage remodeling. International Orthopaedics (SICOT) 2013
  2. Chen H et al. Depth of subchondral perforation influences the outcome of bone marrow stimulation cartilage repair. J Orthop Res. 2011 Aug;29(8):1178-84
  3. Zedde P et al. Second Generation Needling Techniques for the Treatment of Chondral Defects in Animal Model. Joints 2017; 5:27–33
  4. Ibán M A R, et al. Footprint preparation with nanofractures in a supraspinatus repair cuts in half the re-tear rate at 1-year follow-up. A randomised controlled trial. Knee Surg Sports Traumatol Arthroscopy