Microfracture of the Femoral Condyle

Phase I (Weeks 0-8)

1. Weightbearing:  Touchdown weightbearing (20-30% of body weight max) for 6-8 weeks – No Bracing Required
2. Range of Motion – Continuous Passive Motion (CPM) Machine for 6-8 hours per day for 6-8 weeksSet CPM to 1 cycle per minute – starting at level of flexion that is comfortableAdvance 10° per day until full flexion is achievedPassive Range of Motion and stretching under guidance of PT
3. Set CPM to 1 cycle per minute – starting at level of flexion that is comfortable
4. Advance 10° per day until full flexion is achieved
5. Passive Range of Motion and stretching under guidance of PT
6. Therapeutic ExercisesQuadriceps/Hamstring isometricsHeel slides 
7. Quadriceps/Hamstring isometrics
8. Heel slides 

Phase II (Weeks 8-12)

1. Weightbearing:  Advance to full weightbearing as tolerated — discontinue crutch use
2. Range of Motion – Advance to full/painless ROM
3. Therapeutic ExercisesClosed chain extension exercisesHamstring curlsToe raisesBalance exercisesBegin use of the stationary bicycle/elliptical
4. Closed chain extension exercises
5. Hamstring curls
6. Toe raises
7. Balance exercises
8. Begin use of the stationary bicycle/elliptical

 Phase III (Months 3-6)

1. Advance closed chain strengthening exercises, proprioception activities
2. Sport-specific rehabilitation
3. Therapeutic Exercises
4. Range of Motion – Full/Painless ROM
5. Weightbearing:  Full weightbearing
6. Gradual return to athletic activity as tolerated – including jumping/cutting/pivoting sports
7. Maintenance program for strength and endurance