Knee Microfracture Surgery
Knee microfracture surgery is a common surgical procedure used to treat the surfaces of the knee joint when they have become damaged. Damage to the surface of the knee joint is commonly caused by osteochondral lesions. Physiotherapy plays a crucial role in rehabilitation and recovery following knee microfracture surgery.
The surfaces of the bones in the knee joint are covered with a protective layer of osteochondral cartilage. This cartilage is smooth and allows the bones to glide over one another easily during movements. In some cases, as a result of injury or due to wear and tear, small areas of the cartilage layer can get damaged. This damaged can be referred to as osteochondral lesions. Osteochondral lesions can occur in any joint but are most common in the knee and ankle. Such lesions are a tear or fracture in the cartilage covering the bones of the joint. In the knee, damage to the cartilage occurs between the femur (thigh bone) and the tibia (shin bone) or between the femur and the patella (knee cap). Osteochondral lesions if left untreated can cause significant pain and discomfort during weight bearing activities, swelling, dull aching pain, locking or clicking, instability and giving way of the knee joint.
Knee microfracture surgery is recommended to treat damage that occurs on the surfaces of the knee joint such as osteochondral lesions. A microfracture is performed arthroscopically (key hole) by creating small holes into the bone in the affected area of the knee joint surface. The small holes created causes deeper bone cells which are contained in the bone marrow to come to the surface. These cells have a greater blood supply than the surface bone and are effective in stimulating new cartilage growth that will then cover the damaged area. The new cartilage is not as strong as the original layer but will provide an essential coating on the surface of the bones. Additionally, this coating provides protection during movement and therefore will alleviate symptoms such as pain and swelling that result from the osteochondral lesions.
Knee microfracture surgery can be performed on any of the three bones that make up the knee joint including the femur (thigh bone), tibia (shin bone) and patellofemoral joint (where kneecap joins to thigh bone)
Knee microfracture surgery is an effective procedure in the treatment of conditions such as osteochondral lesions and provides significant relief from symptoms such as pain and reduced mobility caused by injury and damage to the surfaces of the knee joint.The surgery is time effective, minimally invasive, and can have a significantly shorter recovery time than an arthroplasty (knee replacement).Knee microfracture surgery will prevent the development of degenerative diseases in the future and also prevent or delay the need for further surgery such as total or partial knee replacement.
Physiotherapy is the key for successful rehabilitation and recovery after knee microfracture surgery. Rehabilitation aims to protect the area treated by the microfracture surgery as well as maintain and improve range of movement and strength within the knee joint.
Physiotherapy before knee microfracture surgery
It is highly recommended to take part in a comprehensive physiotherapy programme before you undergo knee microfracture surgery. Physiotherapy with Physio.co.uk at this stage will help better prepare your knee for the surgery by strengthening the muscles in and around your knee whilst also helping to maintain as much range of movement as possible in your knee in the lead up to the operation. Additionally, physiotherapy will also aim to improve your cardiovascular fitness and muscle endurance which will also help prepare your knee and your body for the microfracture surgery. Activities included in your physiotherapy programme with Physio.co.uk will not only better prepare your knee for the surgery but will also help ensure a successful and problem free recovery once you have had your knee microfracture surgery.
Symptoms after knee microfracture surgery
Following your knee microfracture surgery you will experience some pain which is controlled with effective pain relief and modalities. You will also experience a considerable amount of swelling around your knee which is expected to last for up to several weeks after surgery. This can be controlled using ice and with sufficient elevation of your limb.
After microfracture surgery to your knee joint, the amount of weight put on the area must be limited allowing adequate healing and maximum development of cell growth in the area that underwent the microfracture treatment. Therefore, you will be given elbow crutches to use for up to 6 weeks. You will be shown how to mobilise properly using crutches and start off non weight bearing with a gradual progression to partial weight bearing as tolerated. You will be only allowed to take approximately 25% of your body weight through your operated leg during this time.
After your knee microfracture surgery your knee will feel very stiff and you will experience a significant reduction in range of movement in your knee. It is important to initiate range of movement exercises early therefore you may be put on a continuous passive motion (CPM) machine which will help maintain range of movement after the surgery. However, if the area of the microfracture treatment is the patella or within the groove at the bottom of the thigh bone (patellofemoral joint) then knee motion must be limited for several weeks after the surgery.
You will be unable to drive after your knee microfracture surgery until you have regained full and painless range of movement in your knee. You will be required to partake in a comprehensive physiotherapy course to ensure the success of the surgery and guarantee a rapid and problem free recovery.
Physiotherapy after knee microfracture surgery
Immediate physiotherapy is essential once you have undergone knee microfracture surgery to reduce pain, swelling and stiffness, increase muscle strength, and to return the range of movement in your knee. Physio.co.uk can offer you a comprehensive physiotherapy programme that can provide you with the return of painless and full or near to full function in your knee. Physio.co.uk also aims to give you as much knowledge and education about your recovery to reassure you and keep you aware of your rehabilitation goals and outcomes. Your rehabilitation after knee microfracture surgery may take 3 to 6 months before your knee is fully functional and pain free.
Early stages (0-4 weeks)
Goals in the early stages of your rehabilitation with Physio.co.uk will aim to decrease pain and swelling, improve independence, increase ROM, develop muscle strength, improve muscle control, and improve patella mobility. You will be using elbow crutches and be non weight bearing in the initial stages of your recovery therefore Physio.co.uk will aim to progress your weight bearing ability as tolerated. Your physiotherapy will also include strengthening exercises for your hip, ankle and opposite limb for maximum support for your operated knee after your surgery. Your physiotherapy will include:
- Cryotherapy (Ice)
- Compression and protection using a form of knee brace or immobiliser
- Gentle patella mobilisations as tolerated
- Non weight bearing exercises
- Passive range of movement exercises
- Strengthening exercises for quadriceps, hamstrings and calf muscles
- Stretching of lower limb muscles (e.g. quads, hamstring, calves) as tolerated
- Hip, ankle and opposite leg strengthening exercises
During the second month after your knee microfracture surgery, your physiotherapy programme with Physio.co.uk will focus on pain management, strengthening muscles and increasing the range of movement in your knee. By the sixth week you will no longer need crutches, therefore your physiotherapy will gear towards increasing your tolerance to weight bear, gait re-education and improving proprioception (balance). Physiotherapy activities will include:
- Continuation of modalities for pain and swelling
- Patella mobilisation
- Progression of passive range of movement exercises
- Introduction of active (unassisted) range of movement exercises
- Continuation of strengthening and stretching exercises for quadriceps and hamstrings
- Progression of weight bearing – full weight bearing activities
- Gait re –education training
- Proprioception and balance training
- Hip and ankle strengthening
- Stationary bicycle as tolerated
After 8 weeks of successful physiotherapy with Physio.co.uk you will now be fully weight bearing and should have full and painless range of movement in your knee. Your physiotherapy will now focus on the continuation of strengthening exercises for the muscles in and around your affected knee as well as your hip, ankle and opposite leg for further support. Physio.co.uk will continue to include range of movement exercises, gait re-education, proprioception (balance) training and muscle control exercises. At this stage, your physiotherapy with Physio.co.uk will also include activities that focus on improving your cardiovascular fitness and muscle endurance to further prevent any recurring problems with your knee joint and also help maximise your recovery. Your physiotherapy will include:
- Continuation of strengthening exercises from previous weeks
- Continuation of stretching exercises from previous weeks
- Patella mobilisations
- Active range of movement exercises
- Gait re-education
- Proprioception (balance) training
- Static bicycle (resistance as tolerated)
Later stages (3 months onwards)
Three months after your knee microfracture surgery and undergoing successful physiotherapy with Physio.co.uk you will have seen significant improvements in strength of the muscles in and around your knee, improved range of movement and flexibility as well as increased cardiovascular fitness. By this time, your physiotherapy will continue to focus on improving your cardiovascular fitness and muscle endurance whilst also gearing towards more sport or hobby specific activities.
Full recovery after knee microfracture surgery may take up to 6 months. The success and rate of your recovery highly depend on your commitment and adherence to your comprehensive physiotherapy programme with Physio.co.uk as well as the condition of your knee prior to your knee microfracture surgery.
Knee microfracture surgery is a surgical procedure used in the treatment of areas with damaged cartilage. Damage such as small tears and fractures can be referred to as osteochondral lesions. Osteochondral lesions cause significant pain, discomfort, swelling, and reduced function in the knee joint. Knee microfracture surgery is effective in providing significant relief for the symptoms that are caused by osteochondral lesions. Knee microfracture is recommended to help prevent the progression of degenerative diseases in the future and delay the need for further surgery such as total or partial knee replacement. Physiotherapy after knee microfracture surgery is essential maximise the success of the surgery and ensure the return of full or near to full function of your knee. Physio.co.uk will offer you a personal physiotherapy programme that will help prevent or delay the likelihood of problems such as injury or degenerative diseases occurring in the future. Additionally, a physiotherapy programme with Physio.co.uk will guarantee a rapid recovery of your knee joint and get you back doing whatever it is you love doing the most whether it is your job, hobby or sport! Call Physio.co.uk now on 0330 088 7800 for more information or contact usto book an appointment.