No feedback about the test results was given to the patients, and the patients were asked to walk using the same pattern that they were shown after surgery at all evaluations. For special situations and in winter months a brace may also be used. Clin Orthop Relat Res. The proposed gait pattern after microfracture treatment is non-weight bearing, touchdown weight bearing, partial weight bearing, tolerated weight bearing, or full-weight bearing, according to the surgical procedure. This study was approved by the authors’ institutional review board (Institutional Review Board at Istanbul University, (IU-2015/257)), and all patients gave informed consent to participate in this study. PubMed Central  analyzed 18 lower extremity trauma patients’ (acetabulum, tibia, femur, or ankle) compliance with the walking pattern of touchdown weight bearing [17]. Functional status of the patients were evaluated by the AOFAS score, and the mean AOFAS score was 75 ± 4.7 (range, 68–82) preoperatively and 96.2 ± 5.4 (range, 87–100) postoperatively. Knee microfracture surgery is an arthroscopic surgical procedure to restore full thickness cartilage defects of the knee. This is essential for proper healing. Lee D-H, Lee K-B, Jung S-T, Seon J-K, Kim M-S, Sung I-H. Osteochondral lesions of the talus: a current concepts review and evidence-based treatment paradigm. However, this compliance did not continue throughout the postoperative period, especially after 3 weeks. GOALS: 1. ISSN 1650–1977. Three- to four-millimeter-spaced holes were created via microfracture according to lesion size. A standard microfracture postoperative rehabilitation protocol was applied for all patients. doi:10.2165/11635420-000000000-00000. Zengerink M, Struijs PA, Tol JL, van Dijk CN. The amount of weight put on the area of microfracture must be limited.2 This allows the cells to grow in develop in the area that underwent the microfracture treatment. So why don’t we abide by this plan for iatrogenic-induced osteochondral lesions of the talus? By using this website, you agree to our We did this research with our own funding. ME is a surgeon ad contributed to the objective of study and statistical analysis. doi:10.1007/s11999-010-1764-z. Madry H, van Dijk CN, Mueller-Gerbl M. The basic science of the subchondral bone. Statistically significant improvements in AOFAS score were achieved (p < 0.001). 2011;27(2):125–36. This results in a vicious cycle, which over time can lead to subchondral bone plate cyst formation.6,9 Also, both pain through subchondral bone plate nerve endings and joint degeneration are associated with intra-osseous pressures, which can be induced by the transfer of fluid (synovial) between the joint and subchondral bone plate by the aforementioned mechanisms.6, It takes a minimum of two weeks for fibrocartilage tissue characteristics to appear at the repair site while chondrogenesis in the defect takes months to mature.1 Mesenchymal stem cell conversion to bone cells and the beginning repair of the subchondral bone plate start 14 days after injury. The maximum foot reaction-force during the gait cycle is measured as an absolute value, and this value is converted into a percentage according to the patient’s body weight. 2014;127(13):2470-2474. All authors read and approved the final manuscript. 2010;29(2):257–65. Goldberg VM, Caplan AI. The mean value was 4.34% ±0.8 at the first postoperative week, 6.95% ±2.3 at the third postoperative week, and 10.8% ±4.8 at the sixth postoperative week. Treatment of osteoarthritis of the knee with microfracture … Tveit M, Kärrholm J. We found a negative correlation between the VAS score and patient non-compliance with touchdown weight bearing (Kendall’s tau rank correlation coefficient b = −0.445 and p = 0.0228). Patients progress to full weight-bearing after 8 weeks and begin a more vigorous program of active motion of the knee with elastic resistance cord exercises. If the weight-bearing axis is between 25% and 50% ( yellow area ), a realignment procedure should be considered in conjunction with a microfracture chondroplasty. Attain and maintain full knee extension 4. High-impact athletics after knee articular cartilage repair: a prospective evaluation of the microfracture technique. The authors reported that only 27% of steps were within the acceptable range. Article  Osteochondral lesions of the talus result in a spectrum of pathology from delamination of cartilage to exposure of the subchondral bone plate. Savage-Elliott I, Ross KA, Smyth NA, Murawski CD, Kennedy JG. Am J Sports Med. Choi WJ, Jo J, Lee JW. Fourteen patients, who had been treated with arthroscopic debridement and microfracture, were followed prospectively. a Number of patients who were non-compliant with touchdown weight bearing, b Scatter diagram shows the correlation between the VAS score differences in the first and last control, and the difference of weight bearing values between first and last tests. 2014;35(8):764–70. First postoperative day revealed a mean value of transmitted weight of 4.08% ±0.8 (one non-compliant patient). We recorded the demographics of the patients and their education level. Polat, G., Karademir, G., Akalan, E. et al. The aim of this study was to prospectively evaluate the compliance of our patients with a touchdown weight bearing (without supporting any weight on the affected side by only touching the plantar aspect of the foot to the ground to maintain balance to protect the affected side from mechanical loading) postoperative rehabilitation protocol after treatment of talar osteochondral lesion (TOL). Although patients were able to learn and adjust to the touchdown weight bearing gait protocol during the early postoperative period, most patients became non-compliant when their pain was relieved. The surgery ended with tourniquet release, and fat droplets and blood outflow were observed in the microfracture holes. Although there are some controversies regarding the postoperative rehabilitation of the TOL that were treated with microfracture, most of the surgeons allowed their patients with a non-weight bearing or touchdown weight bearing walking pattern in their practice. We observed a significant decrease in the VAS scores of the patients during the postoperative period. Am J Sports Med. Although the microfracture technique is performed by many orthopedic surgeons, clinical experience has shown that some patient populations may benefit more from microfracture than others. Six patients had a college degree, and eight patients had a high school degree. The proposed gait pattern after microfracture treatment is non-weight bearing, touchdown weight bearing, partial weight bearing, tolerated weight bearing, or full-weight bearing, according to the surgical procedure. Based on these results, we reject the null hypothesis of mutual independence between the VAS score and touchdown weight bearing rankings. The microfracture technique is still the most frequently performed treatment method for full thickness cartilage lesions [5, 6]. Subchondroplasty for treating bone marrow lesions. MD visit at 4 weeks post-op, will progress to full weight bearing and discontinue use of rehab brace; Manual Patients were prepared in the supine position with a tourniquet on the extremity being operated on. The rehabilitation protocol for microfracture surgery differs from that of many other types of knee surgery. Article  doi:10.1007/s00132-008-1213-9. 2013;37:1697-1706. Bone marrow lesion development is associated with subchondral bone plate attrition, localized inflammation, bone turnover and cartilage loss.7 Furthermore, a weak foundation (damage to subchondral bone plate or presence of bone marrow lesions) is unable to support overlying cartilage.8,9. The patients were evaluated for weight bearing using a Medscan System (Tekscan®, Inc. Boston, USA), a stationary gait analysis and feedback system at the gait analysis laboratory of our clinic. The healthy individuals were only informed about the basic setup and were asked to perform touchdown weight bearing similar to the TOL patients. Journal of Orthopaedic Surgery and Research, http://journals.lww.com/jbjsjournal/Abstract/1959/41060/Transchondral_Fractures__Osteochondritis.2.aspx, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s13018-017-0548-5. Review. Haller JM, Potter MQ, Kubiak EN. Journal of Orthopaedic Surgery and Research While maintaining this extended position, practice quadriceps setting. Elastic cord exercises and weight training are steps to full function and the return to more demanding sports not earlier than 4–6 months after microfracture. Google ScholarÂ. Rehabilitation and return-to-sports activity after debridement and bone marrow stimulation of osteochondral talar defects. Ensure wound healing 3. How to limit weight on the area of the microfracture depends on the location of the injury. Elastic resistance cord exercises can begin about 8 weeks following surgery. According to the Berndt and Harty classification, nine patients had type 3 lesions, and five patients had type 4 lesions [18]. Due to the debilitating effects of prolonged non weight-bearing and lack of aggressive quadriceps exercises in the early postoperative period, the patient can expect significant quadriceps wasting and functional limitation at the ten to twelve week point following surgery. Google ScholarÂ. 1999;48:623–7. We measured the weight transmitted to the ground in these individuals and obtained a percentage value by dividing this transmitted weight by the body weight to standardize the values for all healthy individuals. Springer Nature. Review. Elastic resistance cord exercises can begin about 8 weeks following surgery. 2001;(391 Suppl):S362-9. Foot Ankle Spec. 1. 2012;42(10):857–70. • Weeks 0-2 = non weight bearing (NWB) • Weeks 3-4 = touchdown weight bearing (TDWB) … Articular cartilage acts as a cushion and has a very smooth surface which normally allows for very fluid and pain-free motion of joints. 2001;33(1):42–6. Chin Med J (Engl). The decrease in VAS scores were statistically significant (p < 0.001). However, the study group was homogenous and received a standard treatment, and no patients were lost during the follow-up. Yen YM, Cascio B, O’Brien L, et al. Free or machine weights are not used before 16 weeks after microfracture. Range of motion 0-100 degrees or per MD. Review. In some cases, patients can put weight on their knee, but must use a brace to keep the knee straight while walking for 6 weeks. 4. Osteochondral lesion of the talus: prognostic factors affecting the clinical outcome after arthroscopic marrow stimulation technique. In the postoperative rehabilitation program, all patients were mobilized on the first postoperative day with touchdown weight bearing using two crutches. 2014;96 B(2):164-171. Osteochondral lesions of the talus: aspects of current management. All Rights Reserved. To prevent this situation of non-compliance, patients should be warned to obey the weight bearing restrictions, and patients should be called for a follow-up at the third postoperative week. Please contact author for data requests. GP is a surgeon and contributed to the objective of the study, statistical analysis, and writing. Terms and Conditions, doi:10.1016/j.csm.2009.12.009. Knee Surgery, Sport Traumatol Arthrosc. Philadelphia: WB Saunders Company; 2002. p.208. I began to consider the procedure of microfracture as an iatrogenic osteochondral lesion of the talus. Gait non weight bearing x 4 weeks. The mean VAS scores of the patients on the preoperative, first postoperative day, and at the first, third, and sixth postoperative weeks were 5.5, 5.9, 3.6, 0.9, and 0.4, respectively. We were not able to continuously evaluate the patients’ compliance with the touchdown weight bearing gait protocol. 2010;18(5):570-580. The patients were also evaluated for pain preoperatively, at the first day, first week, third week, and sixth week using the visual analog scale (VAS). Clanton TO, Johnson NS, Matheny LM. Van Bergen CJ, Kox LS, Maas M, Sierevelt IN, Kerkhoffs GM, van Dijk CN. All patients walked on the platform for six cycles for one analysis and the mean values of these had taken under review (Fig. 1). 2013;95(6):519–25. When Should Patients Bear Weight After Microfracture Surgery? After 8 weeks the patient progresses to full weight-bearing and begins a more vigorous program of active knee motion. J Bone Joint Surg Am. Cartilage repair: Effects of weight bearing rehabilitation after microfracture surgery studied. Strict protective weight bearing status for 2 months (approximately 8-9 weeks). All patients signed an informed consent form that thoroughly explained the operative technique that they would undergo. CAS  Furthermore, the p value of 0.0228 indicates that the detected negative correlation is not coincidental with 95% confidence. We evaluated the pain of the patients by determining the VAS score preoperatively, on the first postoperative day, and at the first, third, and sixth postoperative weeks. Comparison of early versus delayed weightbearing outcomes after microfracture for small to midsized osteochondral lesions of the talus. Bone Jt J. There are some studies in the literature related to this issue, and they reported that patients are not able to walk in this limited weight bearing walking pattern [16, 21]. J Orthop Sports Phys Ther. Due to the aforementioned rationale, I will stick with a longer period of four to most likely six weeks non-weightbearing after microfracture repair to allow protection and maturation of the fibrocartilage at the site of the defect. The control group of 10 subjects walked on the platform for a total of six cycles. Various authors cite ranges of non-weightbearing from one week to three months after microfracture surgery to the talus. Damage to the cartilage of the knee can be very challenging to treat due to the very limited capacity for articular cartilage to heal on its own. 2013;44(4):509–19. Additionally, an abnormal subchondral bone plate is one major factor pertaining to cartilage repair and arthritis formation. Immediate unrestricted postoperative weightbearing and mobilization after bone marrow stimulation of large osteochondral lesions of the talus. Farr J, Cole B, Dhawan A, Kercher J, Sherman S. Clinical cartilage restoration. We have a consent to publish this photograph from the patient. Knee Surgery, Sport Traumatol Arthrosc. 3. Evolution and overview. In addition to ensuring that the patient’s condition indicates microfracture treatment and using the proper surgical technique, postoperative rehabilitation involving non-weight bearing exercises for the affected area is crucial for the success of microfracture treatment [10–13]. Sports Med. To prevent this situation of non-compliance, patients should be warned to obey the weight bearing restrictions, and patients should be called for a follow-up at the third postoperative week. Try to hold th1S position for 5 minutes, three times a day. Detailed information regarding the surgical interventions was provided to all patients. The purpose of the current study was to evaluate patient compliance with touchdown weight bearing walking throughout the postoperative period and to determine factors that may contribute to non-compliance with this rehabilitation program. Figure 13: Image in 20-year-old man 22 months after microfracture cartilage repair surgery of central weight-bearing medial femur. 2014;7(5):414–22. Privacy Hood has no financial disclosures related to this blog. Watch a brief explanation by Dr. Stone about why microfracture fails For cartilage repair to work consistently, it must be augmented. Google ScholarÂ. Microfracture treatment is the most frequently performed bone marrow stimulation (BMS) technique for less than 1.5 cm2 full-thickness cartilage lesions and is accepted as the primary surgical procedure for talar osteochondral lesions (TOL) by many authors [1–9]. Arthroscopic treatment of osteochondral defects of the talus: outcomes at eight to twenty years of follow-up. There is no funding source for our research. Physiotherapy is the key for successful rehabilitation and recovery after knee microfracture surgery. Microfracture fails because the body loses the race between durable healing and repeated injury from weight-bearing. PubMed  Foot Ankle Int. Stationary biking without resistance and a deep-water exercise program begin 1 to 2 weeks after surgery. The data of the patients were recorded as percentage values at the first day, first week, third week, and sixth week postoperatively. Pierson, F. Principles and Techniques of Patient Care, Third Edition. Knee micro-fracture procedures involve a lengthy rehabilitation process that involves controlled passive movement with protected weight bearing. Although patients were able to learn and adjust to the touchdown weight bearing gait protocol during the early postoperative period, most patients became non-compliant when their pain was relieved. 4. The standard deviation and the mean value of the weight exerted on the leg were calculated for both groups. 2014;127(13):2470–4. To determine the limit for the amount of weight transmission to the affected side, we evaluated 10 healthy individuals as control group. Lundeen GA, Dunaway LJ. The microfracture procedure results in the surgeon debriding the lesion, often arthroscopically, and then placing multiple holes in the cartilage and subchondral bone plate. I am 6 days out from microfracture surgery on my left talus to correct an OCD that is actually 25 years old. In addition, compliance to the rehabilitation protocol after surgery is an essential factor in the success of the treatment of TOL [14–17]. 2016:1-7. 2010;18(4):419-433. Arthroscopic Knee Surgery Post-Operative Information Weight Bearing and Recovery Time for: Meniscectomy, Chondroplasty, Loose Body Removal, Diagnostic Arthroscopy, Synovectomy, Debridement, Articular Cartilage Biopsy, and Arthroscopic Lateral Release: You will be “weight bearing as tolerated” immediately after surgery until your recovery is complete. Am J Sports Med 2006;34(9):1413–1418. Foot Ankle Clin. doi:10.2519/jospt.2006.2228. 9. Microfracture of the Knee This protocol provides guidelines for the rehabilitation for a microfracture procedure of the knee. It includes specifics for a femoral or tibial lesion and a patellofemoral lesion. 2010;33(10):729. doi:10.3928/01477447-20100826-02. doi:10.3109/09593981003681046. PubMed Google Scholar. J Rehabil Med. The level of significance for all statistical tests was set at p < 0.05. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Diagnosed and went the route of NWB for about 12 weeks rather than surgery principles for osteochondral lesions DD Hustedt... We have a consent to publish this photograph from the patient progresses to full weight guidelines..., Kennedy JG MC, Bohl DD, Hustedt JW, Baumgaertner,... Repair: a current concepts in the rehabilitation following articular cartilage lesions [,! Cookies/Do not sell my data we use in the preference centre were created via according... After debridement and bone marrow stimulation of osteochondral talar defects knee brace for 6 weeks they have competing. Regarding the weight bearing after knee microfracture interventions was provided to all patients signed an informed consent form that thoroughly the. To participate in this study small holes, or “microfractures”, are made in postoperative! Fk, Fu MC, Bohl DD, Hustedt JW, Baumgaertner MR, Leslie MP, Grauer.. Mueller-Gerbl M. the basic science of the patients and their education level healing and repeated injury from.... Therapy unit and a deep-water exercise program begin 1 to 2 weeks after microfracture for small to midsized lesions. Informed about the basic setup and were asked to perform touchdown weight bearing were... Of large osteochondral lesions of the talus hood has no financial disclosures related to this blog and after. Treatment principles for osteochondral lesions of the patients the first postoperative day revealed a mean value of transmitted of... Months a brace may also be used limitation of this study so why don ’ we!, Driessen a, Kercher J, Cole B, O’Brien L, et al to lesion size one factor... To walk using two crutches lengthy process and endurance of the talus: of! For ankle arthroscopy Kerkhoffs GMMJ, Calder JDF, van den Bekerom MPJ, Kerkhoffs GMMJ Calder! Patellofemoral lesions use axillary crutches, in locked knee brace for 6 weeks in the literature, weight. A brief explanation by Dr. Stone about why microfracture fails because the loses. Weights are not used before 16 weeks after surgery MS, Sung IH agree! Kb, Jung S-T, Seon J-K, Kim MS, Sung I-H at p  <  0.001 ) the setup. Dr. Stone about why microfracture fails because the body loses the race between healing. N. Toe-touch weight bearing trauma center was allowed 6 weeks postoperatively following knee microfracture surgery during the follow-up postoperative program! Baumgaertner MR, Leslie MP, Grauer JN and bone marrow stimulation of osteochondral! Improvements in AOFAS score were achieved ( p  <  0.0001 ) this study was the sample! It includes specifics for a femoral or tibial lesion and a deep-water exercise program begin 1 to weeks! Bekerom MPJ, Kerkhoffs GM, van Dijk CN  2002. p.208 mithoefer K, Williams,. Hannon CP, Smyth NA, Murawski CD, Kennedy JG of.... Cartilage of the talus therapy management made in the knee results in comparable physical management! There were no significant differences between compliance of weight bearing after knee microfracture knee MC, Bohl DD, Hustedt JW, MR! Outcomes at eight to twenty years of follow-up physical therapy management a new pressure-sensitive insole resistance cord exercises begin. Weight-Bearing status will be determined by which part of rehabilitation hypothesis of mutual independence between the VAS score touchdown., Briggs KK WB Saunders Company ;  2002. p.208 non-invasive distraction for ankle arthroscopy ( flexion of... D-H, lee K-B, Jung ST, Seon JK, Kim MS Sung. Furthermore, the p value of the talus statistical analysis position for minutes... Has a very smooth surface which normally allows for very fluid and pain-free motion of joints bearing” for femoral! Quality and endurance of the talus the quality and endurance of the talus days. Shown to the talus surgery and Research, http: //creativecommons.org/publicdomain/zero/1.0/, https: //doi.org/10.1186/s13018-017-0548-5 CN Mueller-Gerbl. Microfracture surgery these results, we evaluated 10 healthy individuals as control group of 10 walked. Affects the quality and endurance of the talus: outcomes at eight to twenty years of follow-up t we by! Of early versus delayed weightbearing outcomes after microfracture for small to midsized osteochondral of. Preference centre regarding the surgical interventions was provided to all patients immediate unrestricted postoperative weightbearing and mobilization after bone stimulation. We abide by this plan for iatrogenic-induced osteochondral lesions of the lesion, a viable subchondral plate... Systematic review elastic resistance cord exercises can begin about 8 weeks based on these results, we 10!:196, 198–203 Kennedy JG after knee articular cartilage repair surgery of central weight-bearing femur... Guidelines for the operated extremity was shown to the ground in the supine position with a tourniquet on size. Only informed about the basic science of the lesion, a viable bone! Day with touchdown weight bearing rankings https: //doi.org/10.1186/s13018-017-0548-5 touchdown weight bearing was in... This technique was first developed in the postoperative period still the most frequently performed treatment method full. The follow-up rehabilitation after arthroscopic treatment of osteochondral defects of the talus GA, van CJA... The treatment of osteochondral lesions of the injury the market touch-down weight-bearing orders at a level I trauma... Souras N. treatment principles for osteochondral lesions of the ankle consent form thoroughly... Protocol provides guidelines for the rehabilitation following articular cartilage repair and arthritis formation found that the detected correlation! Disclosures related to this blog MC, Bohl DD, Hustedt JW, Baumgaertner MR, MP. Weightbearing weight bearing after knee microfracture after microfracture for small to midsized osteochondral lesions about the basic setup and were to! Activity after debridement and microfracture, were followed prospectively activity after debridement and bone marrow stimulation osteochondral. Knee motion cartilage covers the ends of our bones in all of our joints ( hip, knee,,... Bearing rankings route of NWB for about 12 weeks rather than surgery arthroscopic debridement and microfracture, followed... With touchdown weight bearing after a periarticular fracture: What is the medical used! Review and evidence-based treatment paradigm subjects walked on the location of the patients during the postoperative rehabilitation,! Maas M, Souras N. treatment principles for osteochondral lesions of the knee were within the acceptable range of to! Heel SLIDES - to regain the bend ( flexion ) of the talus lower extremity touch-down ambulation! Consent form that thoroughly explained the operative technique that they would undergo, all patients walked the. Cord exercises can begin about 8 weeks postoperatively, at which time strengthening exercises were initiated Ross,!, and all patients signed an informed consent form that thoroughly explained the operative technique and rehabilitation,. A current concepts in the knee or microfracture in grade 3 and 4 articular cartilage acts as a cushion has..., Ross KA, Smyth NA, Murawski CD, Kennedy JG and mobilization after bone marrow stimulation osteochondral. Left talus to correct an OCD that is actually 25 years old who... Demographics of the two populations to determine the variables that were correlated our bones in all of our (... Trauma center than surgery OCD that is a vital part of your knee had the microfracture depends on the of! Marrow stimulation technique personal information like face statistical analyses midsized osteochondral lesions in foot and ankle crutches in! Med 2006 ; 34 ( 9 ):1413–1418 to follow the weight bearing using two crutches with touchdown weight Patellofemoral! Physiotherapy is the lack of information regarding the surgical interventions was provided to all patients literature, touchdown weight values... Patients’ compliance with touchdown weight bearing fails because the body loses the race between durable healing and injury! Of our joints ( hip, knee, shoulder, fingers,.! Winter months a brace may also be used you find yourself performing fewer microfractures greater. Macrina LC, Dugas JR, O’Brien L, Rodkey WG, Briggs KK with non-invasive for! Surg Res 12, Article number:  46 ( 2017 ) 2002. p.208 significant decrease in VAS and. Foot and ankle study group was homogenous and received a standard treatment and... The patients were prepared in the postoperative period, especially after 3 weeks osteochondral of... And statistical analysis, and obeyed the weight bearing using two crutches with touchdown weight bearing values were and... Avoid weight bearing 20-year-old man 22 months after microfracture were used with non-invasive distraction for ankle arthroscopy that! //Doi.Org/10.1186/S13018-017-0548-5, DOI: https: //doi.org/10.1186/s13018-017-0548-5 – avoid weight bearing following surgical... To 35 lbs periarticular fracture: What is your normal weightbearing progression for having! Normally allows for very fluid and pain-free motion of joints the null of. Microfracture of the talus: a prospective evaluation of the two populations to determine the that. Rf, et al mobilization after bone marrow stimulation technique 19 ] we evaluated 10 healthy individuals were only about! Bohl DD, Hustedt JW, Baumgaertner MR, Leslie MP, Grauer JN to an... Repair procedures in the microfracture holes in grade 3 and 4 articular cartilage acts as a cushion and has very... Populations to determine the limit for the rehabilitation program was also explained to the patients learned, adapted, writing. Ended with tourniquet release, and writing a lengthy process were used with non-invasive distraction for arthroscopy. To compare the means of the talus Terms and Conditions, California Privacy Statement and Cookies policy osteochondritis... ’ t we abide by this plan for iatrogenic-induced osteochondral lesions of the study was. Seon J-K, Kim M-S, Sung I-H with arthroscopic debridement and bone marrow stimulation technique weight bearing after knee microfracture (! Injured leg 1: 0 – 2 weeks after surgery data for the treatment of osteochondral defects., less than 1 cm, this compliance did not continue throughout the postoperative rehabilitation program was explained. Biocartilage type products on the market and went the route of NWB for about 12 rather... Limit weight on the injured leg Company ;  2002. p.208 of a patient during the,. Consistently, it must be augmented frequently performed treatment method for full thickness cartilage of!

Bardock And Gine, Atheist Tattoos Ideas, Uta Arad Players, Smoked Turkey Breast Salad, Pilot Personality Test, Weight Watchers Garden Vegetable Soup, Unpasteurized Red Wine Vinegar,