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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EInjury to the articular cartilage and subchondral bone of the talar dome rarely heals without treatment, and nonsurgical treatment is successful only 45% of the time. Neither approach is recommended for osteochondral lesions of the talus (OLTs), which are best treated by arthroscopic bone marrow stimulation with microfracture surgery, particularly for symptomatic OLTs \u0026lt;15 mm in diameter. This article discusses a comparison of delayed and early weight-bearing postoperative regimens for patients treated by microfracture for small to midsized OLTs.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EFoot \u0026amp; Ankle Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EFoot \u0026amp; Ankle Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EInjury to the articular cartilage and subchondral bone of the talar dome rarely heals without treatment, and nonsurgical treatment is successful only 45% of the time [Verhagen RA et al. \u003Cem\u003EFoot Ankle Clin\u003C\/em\u003E. 2003]. Neither approach is recommended for osteochondral lesions of the talus (OLTs), which are best treated by arthroscopic bone marrow stimulation with microfracture surgery, particularly for symptomatic OLTs \u0026lt; 15 mm in diameter. This procedure is technically simple and minimally invasive with low complication rates and postoperative pain [Ferkel RD et al. \u003Cem\u003EAm J Sports Med.\u003C\/em\u003E 2008].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EHowever, the quality and volume of repair tissue can be affected by postoperative loading, with excessive loads causing destruction of repaired tissue. For this reason, early non-weight bearing range-of-motion exercises for a minimum of 6 to 8 weeks, followed by progression to full weight bearing by 3 months, are widely recommended [Ferkel RD et al. \u003Cem\u003EAm J Sports Med.\u003C\/em\u003E 2008]. Although a few investigators have reported successful outcomes after early weight bearing in patients treated with microfracture for chondral knee and ankle injuries with lesions \u0026lt; 15 mm in diameter [Li S et al. \u003Cem\u003EChin Med J.\u003C\/em\u003E 2014; Lee DH et al. \u003Cem\u003EAm J Sports Med.\u003C\/em\u003E 2012], early and delayed (or non-weight bearing for 6 weeks) postoperative treatments after microfracture have not been compared in a randomized controlled trial.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EKeun-Bae Lee, MD, PhD, Chonnam National University Hospital, Gwangju, Korea, reported that delayed and early weight-bearing postoperative regimens are equally beneficial for patients treated by microfracture for small to midsized OLTs.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EOf 99 patients presenting with OLTs, 41 were randomized to delayed weight bearing and 40 to early weight bearing. For patients in the delayed weight-bearing arm, a posterior splint was applied during the first week. Active ankle range-of-motion and strength exercises were started in the second week. Non-weight bearing was maintained for 6 weeks. After 8 weeks, the posterior splint was removed. Patients in the early weight-bearing arm also received a posterior splint during the first week. Early in week 2, partial weight bearing in a walking boot was allowed, followed by early full weight bearing as tolerated. After 8 weeks, the walking boot was removed.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThere were no significant demographic differences between the 2 arms. The mean age was 36 years; the majority were men; and the mean lesion size was 1.0 cm\u003Csup\u003E2\u003C\/sup\u003E. There were no differences in American Orthopaedic Foot \u0026amp; Ankle Society scores preoperatively or during follow-up out to 24 months between the arms. There were also no differences in visual analogue scale or ankle activity score during postoperative follow-up out to 24 months.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003ENo significant correlations were found between final American Orthopaedic Foot \u0026amp; Ankle Society scores based on sex, age, body mass index, duration of symptoms, or lesion size. Similar outcomes for delayed and early weight-bearing postoperative treatments suggest that either approach can be recommended for patients treated by microfracture for small to midsized OLTs.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/34\/9.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzoqnq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}