Contact ohio state sports medicine at 6142932385 if questions arise. Variances will be communicated by the surgeon directly to rehabilitation services. Microfracture trochlearpatellar defect rehabilitation protocol. Ankle arthroscopy with talus ocd microfracture phase i postoperative period weeks 01 nonweightbearing splint immobilization daily icing, compression and elevation home program phase ii weeks weightbearing. The knee has a medial meniscus and a lateral meniscus which together are called menisci. When should patients bear weight after microfracture surgery. Ankle pumps for swelling and dvt prevention range of motion. T2mapping at 3 t has been optimized for the ankle and can be used to noninvasively evaluate cartilage collagen and. Progression through each phase of rehabilitation is. Postoperative rehabilitative protocol followingelbow. Treatment of osteoarthritis of the knee with microfracture. These protocols have been specifically designed to work with the microfracture techni. Therapeutic arthroscopy with microfracture leads to fibrocartilaginous repair and is an effective treatment of osteochondral lesions of the talus.
Ankle arthroscopy with microfracture for osteochondral defects of the talus suman medda, m. Microfracture in the ankle europe pmc article europe pmc. One hundred five consecutive patients with osteochondral lesions of the ankle who underwent ankle arthroscopy with microfracture were prospectively followed up for a mean of 31. Therapeutic arthroscopy with microfracture leads to. Outcome analysis and outcome predictors of 105 cases. Today, microfracture is still the most commonly utilised articular cartilage repair procedure throughout the world. Ice is applied for 20minute periods 34 times per day. They have been updated and modified to suit the needs of dr. Ankle ligament reconstruction rehabilitation protocol. The rehab program will proceed cautiously for the first 3 months, after which functional progression will be determined by patients tolerance to the exercises and. Menisci are semi lunar wedges that sit between the femur thigh bone. Initially, there was concern regarding the long term outcomes of microfracture surgery, but published reports have demonstrated the procedure to be an effective surgical treatment.
However, the rehabilitation program ultimately determines the success of the procedure. Kavanagh, pac the goal of microfracture rehabilition is to create an ideal physical environment combined with the ideal chemical environment produced by the marrow clot so that a repair cartilage can develop that fill the original defect. Treatment of osteoarthritis of the knee with microfracture and rehabilitation. Articular cartilage defects of the knee are a common cause of pain and functional disability in orthopedics and sports medicine. Microfracture chondral physical therapy protocol phase i. There are various methods of treatment, the main two being bone marrow stimulation through microfracture surgery or cartilage implantation through allograft or autograft methods. Appointments begin physical therapy 23xweek, beginning 25 days postop rehabilitation goals full extension symmetrical to contralateral knee by the first postop visit at 2 weeks.
Ankle microfracture patient rehabilitation guide mr david gordon. Ankle microfracture experiences pain after surgery and recovery advice please hi all, i had a mf on the talus for a cartilage tear only not an ocd on 5th april. Microfracture mfx is frequently used to treat deep cartilage defects in the ankle. Rehabilitation guidelines following microfracture procedures to the knee there are two types of cartilage in the knee. Triple flexionextension hip, knee, ankle bring knee toward chest bringing foot and ankle up straighten leg, pointing toes repeat 30 times. Observe for signs of infection and begin scar management techniques when incision is closed. Rehabilitation guidelines for patellar microfracture please note that these instructions are general guidelines to be followed. Ankle microfracture surgery rehabilitation protocol dr.
Ankle microfracture surgery recovery answers on healthtap. Ankle arthroscopy with microfracture university orthopedics. In each, patient compliance is vital to the success of the procedure. As a 14 year old multisport athlete, she developed a muscle imbalance commonly seen in. Rehabilitation exercises to be done every 2 hours 1.
Microfracture femoral condyle rehabilitation protocol. I did it playing football 1 year ago, as a semi pro royal air force footballer i received almost profesional footballer. The avascular nature of articular cartilage predisposes the individual to progressive symptoms and degeneration due to the extremely slow and oftentimes inability of the cartilage to heal. Rehabilitation guidelines for patellar microfracture. Post operative microfracture protocol western ortho. Surgeons may use the microfracture technique to treat traumatic lesions, which have surrounding cartilage rims, or degenerative joint disease djd lesions. Microfracture outcomes in pro basketball players lower. Keeping these muscles strong can relieve foot and ankle pain and prevent further injury. Ankle microfracture experiences pain after surgery and. Rehabilitation following microfracture surgery lower.
To design an appropriate rehabilitation program after microfracture, the clinician must think about the region that was affected and the kinematics of the knee. Microfracture is a surgical procedure aimed at cartilage regeneration. Triple flexionextension hip, knee, ankle bring knee toward chest bringing foot and ankle up straighten leg, pointing toes repeat 30 times references. Usually it help to rebuild the cartilage but it take time. Microfracture knee protocol northwestern medical center. Microfracture femoral condyle postoperative protocol. Strengthening the muscles that support your lower leg, foot, and ankle will help keep your ankle joint stable. T2mapping at 3 t has been optimized for the ankle and can be used to noninvasively evaluate cartilage collagen and water content. Range of motion early gentle nonweightbearing range of motion. Rehabilitation following microfracture for chondral injury in the knee. Following the microfracture surgical procedure, the rehabilitation program after microfracture is crucial to optimize the success of the surgical technique. This protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. The journal of arthroscopic and related surgery, 241, 106112.
Vail, colorado for the creation of these rehabilitation recommendations. Osteochondral lesions of the talus result in a spectrum of pathology from delamination of cartilage to exposure of the subchondral bone plate. Massachusetts general hospital, boston, ma podiatric relevance. This arthroscopic procedure was first introduced about. Microfracture creates an environment in which pluripotent marrow cells can be stimulated to produce cartilage. The intent of this protocol is to provide guidelines for progression of rehabilitation.
The rehabilitation program is designed to promote the ideal physical environment in which the bone marrow cells. Pdf rehabilitation following microfracture of the knee. Active ankle dorsiflexion foot up and plantarflexion foot down move foot up and down 1 repetition repeat 20 times over 60 seconds. Microfracture success depends not only on the operation.
Patient may return to various sport activities as progressing in rehabilitation and microfracture healing allows. Microfracturedenovo rehabilitation protocol bryan d. Ankle arthroscopy with microfracture for osteochondral defects of. If any concerns or complications arise regarding the patients progress, physical therapy will contact the orthopedic doctor. Stem cells versus microfracture procedure regenexx.
Microfracture for osteochondral lesions of the ankle. Ankle arthroscopy with microfracture revised february 2009 postop days 1 wk 6 crutches non weight bearing nwb x 6wks arom hip and knee calf pumping wiggle toes ankle arom dfpf, alphabet straight legraise slr x 4 short arc quad saq upper body exercises seated or bench only. Arthroscopic microfracture rehabilitation protoc ol. Microfracture initial exercises weeks dr katherine coyner.
Rehabilitation guidelines for femoral osteotomy, acl reconstruction with peroneus longus allograft, open allograft oats, lateral meniscus allograft transplantation, microfracture 2 p a g e progression criteria rom 090 degrees, full ankle rom md clears patient to discharge brace and begin next phase via xray good quad set. The patient will be nwb and use two crutches to protect the repair site and allow the site to heal properly. In abigails case, based upon current medical evidence, microfracture procedure followed by a short course of cookie cutter physical therapy would have exposed her to longterm knee problems. It is not intended to serve as a substitute for clinical decision making. Protect the cartilage transfer avoid weight bearing if instructed to do so 2. Ankle arthroscopy with microfracture for osteochondral. Rehabilitation precautions general wb status varies based on lesion location, size and physician.
Doctors give unbiased, helpful information on indications, contraindications, benefits, and complications. The arthroscopic technique involves clearing damaged tissue from the knee joint and creating tiny holes microfractures in the bone area where the cartilage is defective. The two protocols that we use after microfracture are presented below. Rehabilitation following microfracture of the knee article pdf available in cartilage 12. The specific rehabilitation program after microfracture surgery varies based on location of the chondral defect. Contine nonweightbearing for 6 weeks with crutches.