Microfracture Rehabilitation Protocol – Kevin Kaplan MD

By Kevin M. Kaplan, MD

Microfracture Rehabilitation Protocol Phase I (Weeks 0-8) 

  • Weight bearing: Touchdown weight bearing (20-30% of body weight max) for 6-8 weeks – No Bracing Required
  • Range of Motion – Continuous Passive Motion (CPM) Machine for 6-8 hours per day for 6-8 weeks
    • Set CPM to 1 cycle per minute – starting at level of flexion that is comfortable
    • Advance 10° per day until full flexion is achieved
    • Passive Range of Motion and stretching under guidance of PT
  • Therapeutic Exercises 
    • Quadriceps/Hamstring isometrics
    • Heel slides

Phase II (Weeks 8-12) 

  • Weight bearing: Advance to full weight bearing as tolerated — discontinue crutch use
  • Range of Motion – Advance to full/painless ROM
  • Therapeutic Exercises 
    • Closed chain extension exercises
    • Hamstring curls
    • Toe raises
    • Balance exercises
    • Begin use of the stationary bicycle/elliptical

Phase III (Months 3-6) 

  • Weight bearing: Full weigh bearing
  • Range of Motion – Full/Painless ROM
  • Therapeutic Exercises 
    • Advance closed chain strengthening exercises, proprioception activities
    • Sport-specific rehabilitation
  • Gradual return to athletic activity as tolerated – including jumping/cutting/pivoting sports
  • Maintenance program for strength and endurance

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