Microfracture protocol for patients
At Sharp, we understand that after microfracture surgery you need time to regain your strength. We're here to support you on your road to recovery.
Partnering with you every step of the way
Microfracture is an outpatient surgical procedure used to treat damaged areas of cartilage in the knee joint. During the procedure, a series of deep holes, or microfractures, are completed into the bone around the area of damaged cartilage. The microfractures are made deep enough to reach the underlying marrow, which stimulates healing and regeneration of tissue at the bone's surface.
What to do following your microfracture procedure
Our guidelines help you begin exercising after microfracture surgery and should not be substituted for your physician's advice. Always follow your doctor's instructions with regard to your individual care.
Use of support devices following surgery
Before you leave the hospital or surgery center, you will learn to walk using crutches, including how to "touch down weight bear" (TDWB). You should place no more than 20% of your body weight on the surgical leg.
Unless instructed differently by your physician, you will use crutches to TDWB for six to eight weeks following your surgery. It is important to limit the weight placed on the involved limb as to not compromise the surgery and to optimize healing.
Afterward, you will be able to put as much weight on the surgical leg as is comfortable. Your weight-bearing status will be determined by which part of your knee had the microfracture.
You may be issued a brace depending on which part of your knee had the microfracture. You may not need a brace until you increase your activity. If you receive a brace, you may remove it to apply ice and to use the CPM machine, otherwise use as instructed by your physician.
Exercises for your recovery
You will learn exercises when you initiate therapy. In the meantime, you may begin the following program described below:
Continuous passive motion (CPM)
A CPM machine may be applied immediately depending on the location of your knee lesion. Instructions will be issued with your CPM. If you were given a brace, it may be removed during CPM use. You will use the CPM for 6 to 8 hours in a 24-hour period. This is important to optimize healing.Passive knee range of motion
If a CPM is not provided, do this passive exercise on your own, which requires you to relax the surgical knee and lift it with your nonsurgical leg. Seated, use your nonsurgical leg to raise your surgical leg through your available range of motion. You can perform up to 500 repetitions, 3 times per day.Ice/cryotherapy
Apply ice to the knee for 20 minutes every 2 hours during the day. If a polar care or cryotherapy machine was issued, apply this as instructed. The application of ice often decreases swelling and pain. This is continued until postoperative day seven.
Partial knee bends
Hold on to counter for support. Stand with TDWB on the surgical leg. Only 20% of your body weight is placed on the surgical leg. Perform 2 sets of 15 repetitions, 1 to 2 times a day.
Quadriceps strengthening
Rest leg over small towel roll. Tighten quadriceps muscle on front of leg, trying to push back of knee downward. Do not allow the heel to lift off the table or floor. Hold contraction for 5 seconds. Perform 15 repetitions, 1 to 2 times a day.Hamstring stretch
Using a towel, stretch the muscles on the back of your leg. Hold the stretch 1 minute. Repeat twice, 1 to 2 times a day.Calf stretch
Using a towel, stretch the muscles on the back of your calf. Hold the stretch for 1 minute. Repeat twice, 1 to 2 times a day.Hip strengthening
Abduction: Hold on to counter for support. Raise surgical leg out to the side. Do not allow knee to bend. Repeat 15 times. Do 2 sets, 1 to 2 times a day.
Extension: Raise surgical leg behind you. Do not allow the knee to bend. Repeat 15 times. Do 2 sets, 1 to 2 times a day.
Rehabilitation schedule
The location of your lesion and microfracture will determine your rehabilitation schedule. Your doctor will explain the location of your lesion so that you know which of the following programs to follow.
Femoral condyle/tibial plateau lesions
After surgery, you will wake in the recovery room and a nurse will monitor you
Begin CPM or passive range of motion
Wear brace, if issued
Use crutches to walk, TDWB only
Ice
Continue CPM and ice regimen
Begin the following exercises: partial knee bends, quadriceps strengthening, hamstring stretch, calf stretch and hip strengthening (see exercise directions above)
Follow-up appointment with your physician between postoperative days 10 to 14
Your physician may recommend initiating physical therapy at this time or you will be asked to wait until six to eight weeks after surgery
Begin riding stationary bike (without resistance) if you have sufficient range of motion
Attend physical therapy
Progress to full weight bearing (FWB) on the surgical leg
Discontinue crutch use during this time unless otherwise instructed by your physician
Resume free weights and machines independently in gym
Patellofemoral/trochlear lesions
After surgery, you will wake in the recovery room and a nurse will monitor you
Begin CPM
Wear brace at all times to limit bending knee
Use crutches to walk
Ice
Continue CPM and ice regimen
Begin the following exercises: quadriceps strengthening, hamstring stretch, calf stretch, hip strengthening (see exercise directions above)
Follow-up appointment with your physician between postoperative days 10 to 14
You will progress to FWB on the surgical leg and discontinue crutch use during this time unless otherwise instructed by your physician
Begin physical therapy during months two to four
Resume free weights and machines independently in gym