Walking After Microfracture Knee Surgery

The recovery period for micro-fracture surgery can be lengthy. In this article we discuss the kind of activities that are recommended post-surgery.

Can I walk after Micro-fracture Knee Surgery?

Walking may be permitted after surgery if axillary (arm) crutches are used to keep all weight off of the affected knee, or if a knee brace is applied to keep the knee straight. Non-weight bearing activity or touch down weight bearing will most likely be recommended for the first two to six weeks after a micro-fracture knee surgery. See below for further details about different types of weight-bearing activities.

Post-operative recommendations can vary depending on the severity of the injury, age, unique anatomy, and physical and health status of an individual. For example, in some cases, patients can put some weight on their affected leg but must use a brace to keep the knee straight while walking. This brace may need to be worn for up to six weeks or longer.

It is important to talk to your doctor about postoperative restrictions, recovery recommendations, rehabilitation and mobility devices to expect after a micro-fracture knee surgery.

Indications for Micro-fracture Knee Surgery

Micro-fracture knee surgery is done to correct chondral defects of the knee joint. (This type of surgery can be done in other joints like elbows, but this article talks specifically about the knee joint.) Chondral (pronounced kon-drul) is the medical term used to refer to articular cartilage or cartilage of the joint.

Cartilage covers the ends of our bones which helps them to glide smoothly with movement. When there is damage to this cartilage it creates friction with movement which can cause severe pain and inflammation. Think about the difference between rubbing two pieces of wax paper together (normal joint) and then rubbing two pieces of sandpaper together (articular chondral injury).

Micro-fracture knee surgery is done to repair this damage, returning the cartilage to its naturally smooth surface.

When you have severe pain in the knee with walking, standing, jumping or other movements surgery of this type may be indicated.

Key Indications

  • Patient is young
  • Patient has symptoms of full thickness cartilage injury
  • The size of injury is less than 2 square centimeters
  • Bone structure of knee is aligned
  • Patient is committed to doing rehab and recovery exercises

Contraindications for Micro-fracture Knee Surgery

  • Over 65 years old
  • Inability to use the unaffected leg
  • Bone structure of knee is not aligned
  • Partial thickness lesion

Micro-fracture Knee Surgery Explained

As previously mentioned, micro-fracture knee surgery is a procedure done to correct articular cartilage injury of the knee joint.

Micro-fracture knee surgery is an arthroscopic procedure meaning that in can be done without making a large incision. Doctors are able to visualize the joint with a scope inserted below the skin until the joint can be seen.

When visualized, another tool (or awl) is used to make little holes, otherwise known as micro-fractures. These holes are made in the subchondra or in the base of the bone or bones affected, depending on the extent of injury. The micro-fractures are made close together, approximately 3-4 mm apart.

These holes are made in order to promote blood flow and healing to the previously injured cartilage. Over time, the blood and marrow comes from the bone to fill in the holes. This “super clot,” comprised of blood and marrow, turns into fibrocartilage which provides for a rich environment to regenerate new cartilage which ultimately helps to smooth over the previously damaged cartilage.

The process of blood and marrow filling in the micro-fractures and turning into fibrocartilage takes time! While patients will obviously not be bedridden for the whole recovery time, a complete recovery (returning to sports and resuming other pre-surgery activities/abilities) can take about six to nine months.

Timeline and Progression of Activity after Surgery

*The following recommendations depend on the type of micro-fracture knee surgery you have. Different recovery timelines exist for varying degrees of injury and can change according to age, health and unique anatomy.

Non-weight bearing activity (NWB) is defined as bearing no weight on the affected part; therefore, it is possible to move around by hopping on the unaffected leg with crutches or assistance devices but not put any weight on the affected leg. Often you will have NWB restrictions for the first two weeks after surgery.

As healing progresses, you will gradually be able to increase your level of activity to touchdown weight bearing (TDWB). This means you can put the leg onto the floor for balance to help with walking or standing but not actually use it to bear any weight. Often TDWB is indicated in weeks three and four following surgery.  

Then, for post-surgical weeks five and six, you will progress to weight bearing as tolerated (WBAT). This simply means you can put as much weight onto the affected leg as you can tolerate. If it causes pain, apply less weight. If you do not have pain, continue applying weight slowly and increasing activity as tolerated.

Post-operative Activities and Exercises

While you are recovering you will likely need to complete different exercises and stretches and/or attend physical therapy. Exercises, movement and stretches can be crucial in the promotion of healing in the repaired knee joint.

Range of motion (ROM) exercises will likely be prescribed by a physical therapist or doctor. Your physical therapist, doctor, or nurse will show you how to do these exercises at home. Range of motion simply means varying movements of the joint. ROM activities are usually classified as active or passive. Active ROM means: you move it yourself. Passive ROM means: a machine or person moves the bones and joint for you.

A typical goal for the first six weeks after surgery is to do four-eight hours of ROM per day.

One post-operative activity you will likely need to do is wear a machine that performs continuous passive motion, or CPM. CPM is important because it keeps your muscles and joints moving while not applying any stress directly to affected areas. The machine slowly and continuously will move your knee joint. It is recommended to do CPM about seven hours per day for the first six weeks after surgery.

Another activity you will likely need to do is attend physical therapy. This will likely be indicated for one to two times per week. Goals will be set between you and your therapist for walking, bearing weight, extending or bending the knee, etcetera.

As you continue healing and the fibrocartilage begins to generate, a physical therapist will give you more challenging exercises to try. You will be coached into doing activities such as stationary biking, balancing, squatting, among others.

It is important to follow the guidelines of a specialist, such as your doctor, orthopedic surgeon, or physical therapist when regaining strength and mobility in your recovery. If you try it on your own you could further injure yourself.

One of the most important things you can do to recover is to follow the instructions of a professional and do the recommended exercises!

Speak Your Mind