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Are Weightbearing Restrictions Required After Microfracture for Isolated Chondral Lesions of the Knee? A Review of the Basic Science and Clinical Literature.

Publication ,  Journal Article
Jain, D; Belay, ES; Anderson, JA; Garrett, WE; Lau, BC
Published in: Sports Health
March 2021

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 mm2) 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.

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Published In

Sports Health

DOI

EISSN

1941-0921

Publication Date

March 2021

Volume

13

Issue

2

Start / End Page

111 / 115

Location

United States

Related Subject Headings

  • Weight-Bearing
  • Knee Injuries
  • Humans
  • Cartilage, Articular
  • Biomechanical Phenomena
  • Arthroplasty, Subchondral
  • 4207 Sports science and exercise
  • 4201 Allied health and rehabilitation science
  • 3202 Clinical sciences
  • 1106 Human Movement and Sports Sciences
 

Citation

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Jain, D., Belay, E. S., Anderson, J. A., Garrett, W. E., & Lau, B. C. (2021). Are Weightbearing Restrictions Required After Microfracture for Isolated Chondral Lesions of the Knee? A Review of the Basic Science and Clinical Literature. Sports Health, 13(2), 111–115. https://doi.org/10.1177/1941738120938662
Jain, Deeptee, Elshaday S. Belay, John A. Anderson, William E. Garrett, and Brian C. Lau. “Are Weightbearing Restrictions Required After Microfracture for Isolated Chondral Lesions of the Knee? A Review of the Basic Science and Clinical Literature.Sports Health 13, no. 2 (March 2021): 111–15. https://doi.org/10.1177/1941738120938662.
Jain, Deeptee, et al. “Are Weightbearing Restrictions Required After Microfracture for Isolated Chondral Lesions of the Knee? A Review of the Basic Science and Clinical Literature.Sports Health, vol. 13, no. 2, Mar. 2021, pp. 111–15. Pubmed, doi:10.1177/1941738120938662.
Journal cover image

Published In

Sports Health

DOI

EISSN

1941-0921

Publication Date

March 2021

Volume

13

Issue

2

Start / End Page

111 / 115

Location

United States

Related Subject Headings

  • Weight-Bearing
  • Knee Injuries
  • Humans
  • Cartilage, Articular
  • Biomechanical Phenomena
  • Arthroplasty, Subchondral
  • 4207 Sports science and exercise
  • 4201 Allied health and rehabilitation science
  • 3202 Clinical sciences
  • 1106 Human Movement and Sports Sciences