Microfracture
Posted on Thu, Jan 19, 2012 @ 06:35 AM
Microfracture is a surgical procedure aimed at cartilage regeneration most commonly performed in the knee. Cartilage allows for the bones to glide smoothly over one another and, as a result of injury or trauma, some of this cartilage may become removed from the bone causing every day activities such as squatting, kneeling or performing stairs as well as more complex movements such as jumping, cutting or playing sports to be painful. If your doctor recommended this procedure it is important to know the restrictions and rehab process in order to ensure the best possible outcome of the surgery.
The most important initial aspects are range of motion and weight bearing restrictions. The sooner the motion is restored in your knee the better and, by starting physical therapy 3-5 days after surgery, you will decrease the risk of adhesions and scar tissue formation which could lead to joint contractures. Your therapist will give you a home stretching and range of motion program to help with your motion progress when not in therapy. Furthermore, it is important to not put any weight on your leg for 6 weeks to ensure that the clot that is formed from the surgery to promote the new cartilage does not become displaced.
Within these first 6 weeks you and your therapist will be working toward:
1. Reduce pain and swelling by using modalities such as ice or electric stimulation
2. Restore soft tissue balance by using techniques such as stretching, soft tissue mobilizations, massage and passive range of motion to improve knee flexion and extension
3. Restore muscle function by performing non-weight bearing exercises for the hip, knee and ankle. The therapist may also use electric stimulation to help stimulate the quadriceps muscle group to contract and stay strong.
After week 6 and your doctor has cleared you to become weight bearing, you will be working towards:
1. Improving your gait mechanics by decreasing your use of brace and crutches and educate on the proper mechanics of walking
2. Increase proprioception and neuromuscular control by performing balance exercises
3. Continue to improve muscle strength and function by increasing strengthening exercises to squatting, hip and glute strengthening, biking, lunges, stairs and weight machines if present in clinic
Between week 12 and 16 you and your therapist will be introducing jogging and agilities such as jumping and cutting. Your therapist will customize your program depending on your goals and activities or sports that you want to get back to performing.
Everyone will progress differently through the program based on age and past medical history and with close communication with your therapist, exercises may be added at different stages based on symptoms and progress. Finally, patient compliance in terms of completing the home exercise program and attending regular therapy sessions will ensure the best possible rehab outcomes.
-- LaChance