Study Results Put Knee Patients Back on Their FeetThe results of this study challenge current thinking on follow-up treatment after microfracture. Microfracture is an arthroscopic operation for cartilage tears in the knee. The surgeon makes several holes in the layer of bone underneath the damaged cartilage. This brings blood to the injured cartilage and speeds up healing.
Right now doctors are following a standard rehab program. The patient puts no weight on the leg and uses continuous passive motion (CPM). CPM is done with a device that slowly bends and straightens the knee over and over. The idea is to use CPM to put "dynamic" (moving) pressure but no weight through the joint to enhance healing.
In this study two groups of patients were compared. Group one was treated with the standard rehab (non-weight bearing and CPM). CPM was done for at least six to eight hours each day for six weeks. Group two was allowed to walk on the leg and didn't use CPM. Patient results were followed for up to six years.
The researchers report no differences between the two groups. X-rays, activity levels, and number of infections or blood clots were used as measures of results. They concluded the use of CPM and a nonweight-bearing status aren't needed after microfracture.
However, based on the results of this study (only 60 percent had good results), the authors suggested microfracture as a treatment for damaged cartilage should be re-evaluated. Perhaps this method isn't the best way to stimulate healing after all.
Richard A. Marker, M.D., et al. Arthroscopic Microfracture of Chondral Defects of the Knee: A Comparison of Two Postoperative Treatments. In Arthroscopy. February 2005. Vol. 21. No. 2. Pp. 152-158.
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