2017 ISAKOS Biennial Congress ePoster #217

 

Early Versus Delayed Weight-Bearing Following Microfracture Surgery: A Systematic Review of Outcomes and Complications

Darren L. de SA, MD, FRCSC, Hannon, ON CANADA
Patrick Thornley, MD, Hamilton CANADA
Gavinn Niroopan, MD, Hamilton CANADA
Moin Khan, MD, MSc, FRCSC, Hamilton, ON CANADA
Colm McCarthy, MD, Hamilton CANADA
Nicole Simunovic, MSc, Hamilton, ON CANADA
John Adamich, BSc (Cand), Hamilton CANADA
Sahab Jamshidi , MD, Hamilton CANADA
Forrough Farrokhyar , PhD, Hamilton, ON CANADA
Devin Peterson, London, ON CANADA
Volker Musahl, MD, Pittsburgh, PA UNITED STATES
Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, Hamilton, ON CANADA

McMaster University, Hamilton, ON, CANADA

FDA Status Not Applicable

Summary

The purpose of this study was to explore whether, after microfracture, early or delayed post-operative weight-bearing status influences patient outcomes and complications. There was no significant difference in functional scores between early versus delayed weight-bearing following microfracture surgery for the treatment of chondral lesions – irrespective of lower extremity joint.

Abstract

Introduction

The purpose of this study was to explore whether, after microfracture, early or delayed post-operative weight-bearing status influences patient outcomes and complications.

Methods

Databases (CINHAL, MEDLINE, EMBASE, PubMed and Web of Science) were searched for studies addressing weight-bearing following microfracture surgery. Two reviewers conducted a full-text review of eligible studies and the references of these studies. Inclusion criteria included studies conducted on human subjects who underwent microfacture, commented on a post-operative weight-bearing protocol, had outcomes data reported, and were published in English. Exclusion criteria included review articles, technique papers and non-English-language studies. All included studies underwent a quality assessment, and data was abstracted and separated by joint – hip, knee, and ankle. Descriptive statistics are presented.

Results

We identified and included 46 studies (5 hip studies, 22 knee studies, 19 ankle studies) of very-low methodological quality. No included hip studies examined early weight-bearing or any functional protocol assessment. With respect to knee studies, only 20 of a total of 900 patients followed an early weight-bearing protocol, and there were no statistically significant differences across a variety of validated outcomes scores, nor any complications or reoperations reported between either groups. This observation extended to the ankle studies, with a non-statistically significant difference in functional scores and the rate of complications or re-operations between both groups.

Conclusion

There was no significant difference in functional scores between early versus delayed weight-bearing following microfracture surgery for the treatment of chondral lesions – irrespective of lower extremity joint. These results should be interpreted with caution due to the small sample size and low methodological quality of the included studies.