Microfracture

The rehabilitation program after microfracture for treatment of chondral defects is crucial to optimal recovery after surgery [13-16]. Rehabilitation is designed to promote the ideal physical environment in which newly recruited mesenchymal stem cells from the marrow can differentiate into the appropriate articular cartilage-like cell lines [17]. The size and anatomic location of the chondral lesion will determine the specific progression of rehabilitation (Table 3) [13-16].

Postoperatively, flexion ROM is limited to 90° to protect the joint from postoperative impingement for 10 days. Passive ROM should focus on all planes of motion, progressing flexion as tolerated after 10 days. Weight bearing is

Table 1

Labrai repair

Phase I: initial exercise Ankle pumps

Gluteal, quad, HS, T-ab isometrics

Stationary biking with minimal resistance

Passive ROM (emphasize IR)

Piriformis stretch

Passive supine hip roll (IR)

Water walking

Quadriped rocking

Standing hip IR (stool)

Heel sides

Hip abd/add isometrics Uninvolved knee to chest Prone IR/ER (resisted) Sidelying clams

3-way leg raises (abd, add, ext) Water jogging Dbl leg bridges w/tubing Kneeling hip flexer stretch Leg press (limited weight) Short lever hip flexion/straight leg raises Phase II: intermediate exercises Double 1 /3 knee bends Side supports

Week

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