Are Weightbearing Restrictions Required After Microfracture for Isolated Chondral Lesions of the Knee? A Review of the Basic Science and Clinical Literature
| Autor: | Deeptee Jain, William E. Garrett, Brian C. Lau, John A. Anderson, Elshaday S. Belay |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Cartilage
Articular Protocol (science) 030222 orthopedics medicine.medical_specialty Rehabilitation business.industry Basic science Arthroplasty Subchondral medicine.medical_treatment Focus Topic: Knee Physical Therapy Sports Therapy and Rehabilitation Context (language use) Knee Injuries 030229 sport sciences Clinical literature Biomechanical Phenomena Weight-Bearing 03 medical and health sciences 0302 clinical medicine Physical therapy Humans Medicine Orthopedics and Sports Medicine business |
| Zdroj: | Sports Health |
| ISSN: | 1941-0921 1941-7381 |
| DOI: | 10.1177/1941738120938662 |
| Popis: | Context: A strict rehabilitation protocol is traditionally followed after microfracture, including weightbearing restrictions for 2 to 6 weeks. However, such restrictions pose significant disability, especially in a patient population that is younger and more active. Evidence Acquisition: An extensive literature review was performed through PubMed and Google Scholar of all studies through December 2018 related to microfracture, including biomechanical, basic science, and clinical studies. For inclusion, clinical studies had to report weightbearing status and outcomes with a minimum 12-month follow-up. Study Design: Clinical review. Level of Evidence: Level 3. Results: Review of biomechanical and biology studies suggest new forming repair tissue is protected from shear forces of knee joint loading by the cartilaginous margins of the defect. This margin acts as a shoulder to maintain axial height and allow for tissue remodeling up to at least 12 months after surgery, well beyond current weight bearing restriction trends. A retrospective case-control study showed that weightbearing status postoperatively had no effect on clinical outcomes in patients who underwent microfracture for small chondral (2) defects. In fact, 1 survey showed that many orthopaedic surgeons currently do not restrict weightbearing after microfracture. Conclusion: This clinical literature review suggests that weightbearing restrictions may not be required after microfracture for isolated tibiofemoral chondral lesions of the knee. Strength of Recommendation Taxonomy: C. |
| Databáze: | OpenAIRE |
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