Microfracture surgery is performed on people with cartilage tears of the knee. By creating microfractures in the underlying bone, blood and bone marrow leak out from the fractures, which can help to create new cartilage. This helps to heal the previously-untreatable tears in the meniscus. It is extremely important to follow rehabilitation protocol for eight weeks following surgery to ensure the best possible recovery.
RICE
After microfracture surgery, follow the R.I.C.E. protocol -- rest, ice, compression, and elevation -- to reduce swelling and control pain. No weight-bearing exercises, including walking, are permitted in the first eight weeks following surgery. This is to allow the bone to and cartilage to heal. Ice the affected knee for up to 20 minutes at a time every two hours as needed. Do not apply ice directly to bare skin. Wear the brace and surgical wrap as applied by your surgeon. This applies compression and support. Keep the knee at heart level or higher to reduce inflammation.
Continuous Passive Motion
CPM, or continuous passive motion, is provided by a specialized machine. Designed for use in post-operative scenarios, the CPM does the work for the patient by very slowly moving the joint using a motorized device. This continuous movement helps prevent the formation of scar tissue, reduces stiffness and improves range of motion. The surgeon prescribes the duration of usage, speed, rate of increase of motion and amount of motion the machine is to provide. This CPM machine is prescribed by many surgeons to be used for eight weeks following the surgery, after which time the patient begins full rehab on the knee.
Range of Motion Exercises
Once the initial post-operative eight weeks has elapsed, the patient is prescribed physical therapy where he or will meet a therapist and have a rehab schedule designed. Range of motion exercises may include heel slides, where the heel is pulled toward the buttocks while the patient is lying down or sitting on a flat surface; prone leg hangs, where the patient lies face-down on a table with his knees and lower legs hanging off the edge of the table; and standing full extensions, where the affected leg is placed on a table or chair while the patient stands, and the knee is allowed to fully hyperextend. These exercises should be done two to three times a day.
Caution
It is vitally important to follow your surgeon's advice for post-operative recovery. The maximum weight permitted on the affected leg is usually 20 to 30 percent of the patient's bodyweight during touch-down walking while on crutches. No weight-bearing exercises are permitted for the first eight weeks. CPM machines are usually prescribed as well. Use the machine as indicated by your surgeon. Failure to follow these instructions may result in improper healing and injury. Once your physical therapy is assigned, follow the directions of your therapist to regain preinjury strength and range of motion.
