Microfracture Rehabilitation

Protocol for Tibio-Femoral Microfracture

The Microfracture technique is used in knees where there is a defect in the articular cartilage.
These chondral injuries will progress to arthritic changes if left unaddressed.

During the operation the full thickness articular cartilage defect is identified and the exposed bone debrided. Multiple holes or ‘microfractures’ are made in the subchondral bone plate. A blood clot rich in marrow elements: ‘super clot’, forms over the lesion. This clot provides a rich medium in which cells can divide. These eventually form a repair cartilage that fills the original defect.

Patients should have CPM immediately after surgery from 30-70 and then gradually increased
over the next few hours. Pain is the guiding factor limiting ROM. The primary goal is to regain full passive knee motion as soon as possible.

 

Protocol for Patello-Femoral Microfracture

The Microfracture technique is used in knees where there is a defect in the articular cartilage.
These chondral injuries will progress to arthritic changes if left unaddressed.

During the operation the full thickness articular cartilage defect is identified and the exposed boned debrided. Multiple holes or ‘micro fractures’ are made in the subchondral bone plate. A blood clot rich in marrow elements: ‘super clot’, forms over the lesion. This clot provides a rich medium in which cells can divide. These eventually form a repair cartilage that fills the original defect.

These patients will return from theatre in a brace. The range of motion restriction is decided in
theatre and strict attention should be paid to the operation notes for guidance. The brace stops the defect coming into contact with the patella facet as the repair cells are forming.

The primary goal is to regain full passive knee motion as soon as possible.

 

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