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Walking After Microfracture Knee Surgery

Can I walk after Micro-fracture Knee Surgery?

Usually you are unable to bear weight on the affected leg for at least 6 weeks following surgery. You will likely require crutches to get around.  Usually after an initial period of non-weight bearing to the surgical leg, you will be allowed to slowly progress back to normal activities.

It is important to talk to your surgeon about postoperative restrictions, recovery recommendations, and the expected need for rehabilitation and assistive devices following a micro-fracture surgery.

Ultimately, the decision regarding if and for how long you will be non-weight bearing will be made by your surgeon.

Indications for Micro-fracture Knee Surgery

Micro-fracture knee surgery is done to treat chondral defects of the knee joint. Chondral (pronounced kon-drul) is the medical term used to refer to articular cartilage or cartilage of the joint.

Articular cartilage covers the ends of our bones in all of our joints (hip, knee, shoulder, fingers, etc.) Articular cartilage acts as a cushion and has a very smooth surface which normally allows for very fluid and pain-free motion of joints. When there is damage to this cartilage, the once frictionless motion is interrupted —- this can lead to inflammation within the knee and consequent pain.

A chondral injury (or defect)  is a broad term that encompasses any injury to the articular cartilage.  This can include damage to a very small or a very large piece of cartilage. This can result in a cartilage flap that flips back and forth within the joint with knee motion, resulting in pain and even mechanical symptoms (clicking, popping, catching of the knee).

Micro-fracture knee surgery is one way of treating these chondral injuries.  It attempts to stimulate growth of cartilage where the chondral defect is in hopes of recreating a smooth joint surface  It is important to remember, that the cartilage that this procedure generates is not normal articular cartilage — it is a different type of cartilage called fibrocartilage. This potentially affects the long-term success rates of this type of surgery. It is thus important to discuss the expectations of surgery with your orthopedic surgeon.

Not all chondral injuries require micro-fracture.  Additionally, your age, the size and location of the lesion will also determine if this surgery is for you. For the most part, this surgery is indicated in younger patient with smaller cartilage lesions. 

How Micro-fracture is Performed

Micro-fracture knee surgery is an arthroscopic procedure that is performed through very small skin incisions. Using a small camera, orthopedic surgeons are able to directly visualize the area being treated. Once visualized, another tool (an awl) is used to make little holes in the bone (its these holes that are referred to as micro-fractures). 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 area. It stimulates the formation of a “super clot,” comprised of blood and marrow which ultimately turns into fibrocartilage. This helps to smooth over the previously damaged area of cartilage.

The healing process takes time! A complete recovery (returning to sports and resuming other pre-surgery activities) can take several months or more. 

Timeline and Progression of Activity after Surgery

*Different recovery timelines exist for varying degrees of injury and can change according to age, health and one’s unique anatomy.

Usually your surgeon will have you non-weight bearing on the affected leg  for at least 6 weeks following surgery. You will likely require the use of crutches to get around.  Usually after an initial period of non-weight bearing to the surgical leg, your surgeon will allow you to slowly increase the amount of weight you put on your surgical leg.

For instance, after 6 weeks, your surgeon may have you progress to touchdown weight bearing. This means that you can rest your foot on the floor for balance only when standing or walking. However, you are not allowed to bear any weight on it. 

Following this, you will be allowed to slowly progress back to normal activity as tolerated. What this means is that you can put as much weight on to the affected leg as you can tolerate. i.e. if putting full weight on it causes pain, you just put less weight on it — slowly increasing the amount of weight you put through the leg as tolerated. 

It is important to talk to your surgeon about postoperative restrictions, recovery recommendations, and the expected need for rehabilitation and assistive devices following a micro-fracture knee surgery.

Ultimately, the decision regarding if and for how long you will be non-weight bearing will be made by your surgeon.

Post-operative Activities and Exercises

While you are recovering, your surgical team will likely have you involved in therapy to keep the muscles strong and the joint from becoming stiff. Strengthening and range of motion exercises promote healing of your micro-fractured knee. 

Range of motion activities are ones that encourage normal motion of the knee. These activities can be classified as active or passive. With active range of motion exercises, you move the knee yourself. With passive range of motion exercises, someone or something else moves the joint for you.  

At some point following surgery, your surgeon will have you begin formal physical therapy.  This may be right after surgery, or several weeks later. Once this begins, you will typically attend 2-3 sessions a week while your knee heals and while you slowly progress back to normal activities. 

It is important to follow the rehabilitative guidelines laid out by your orthopedic surgeon and physical therapist while you recover. If you try to push yourself too hard or do exercises that you shouldn’t be doing, you may hurt yourself.

Note that the information in this article is purely informative and should never be used in place of the advice of your treating physicians.

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