No difference in outcome between early versus delayed weight-bearing following microfracture surgery of the hip, knee or ankle: a systematic review of outcomes and complications
Notice bibliographique
Résumé
ImportanceInjuries to hyaline cartilage have poor healing potential. Microfracture is often used to treat these lesions; yet, significant variation exists in postoperative rehabilitation protocols.ObjectiveTo systematically examine the evidence on the effects of postoperative weight-bearing status after microfracture surgery. We aimed to ascertain the surgical outcomes and complications associated with patients undergoing microfracture surgery for chondral lesions of the hip, knee or ankle assessing for any difference in outcome between early versus delayed weight-bearing postoperatively.Evidence reviewA literature search was performed through five databases (CINHAL, MEDLINE, EMBASE, PubMed and Web of Science) identifying studies addressing weight-bearing following microfracture surgery published between 1990 and March 2015. 2 reviewers conducted a full-text review of eligible studies and the references of these included studies. Inclusion criteria included studies conducted on human subjects who underwent microfracture with a described postoperative weight-bearing protocol; had outcomes data reported and were published in English. Exclusion criteria included review articles, non-surgical studies, technique papers and non-English language studies. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) criteria were used to evaluate the quality of the evidence among all included studies and data were abstracted and separated by joint—hip, knee and ankle. Descriptive statistics are presented.FindingsWe identified and included 46 studies (5 hip studies, 22 knee studies and 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 microfracture studies, only 20 of a total of 900 patients followed an early weight-bearing protocol. Given the discrepancy between early and delayed weight-bearing sample sizes available, comparative analyses of outcome scores and complications/reoperations were not pursued. With respect to ankle microfracture studies, there were no differences in functional scores and the rate of complications or reoperations between early and delayed weight-bearing groups.Conclusions and relevanceThere is insufficient evidence to draw any meaningful conclusions with respect to differences in functional scores between early versus delayed weight-bearing following microfracture surgery for the treatment of chondral lesions in the hip, knee and ankle. Injuries to hyaline cartilage have poor healing potential. Microfracture is often used to treat these lesions; yet, significant variation exists in postoperative rehabilitation protocols. To systematically examine the evidence on the effects of postoperative weight-bearing status after microfracture surgery. We aimed to ascertain the surgical outcomes and complications associated with patients undergoing microfracture surgery for chondral lesions of the hip, knee or ankle assessing for any difference in outcome between early versus delayed weight-bearing postoperatively. A literature search was performed through five databases (CINHAL, MEDLINE, EMBASE, PubMed and Web of Science) identifying studies addressing weight-bearing following microfracture surgery published between 1990 and March 2015. 2 reviewers conducted a full-text review of eligible studies and the references of these included studies. Inclusion criteria included studies conducted on human subjects who underwent microfracture with a described postoperative weight-bearing protocol; had outcomes data reported and were published in English. Exclusion criteria included review articles, non-surgical studies, technique papers and non-English language studies. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) criteria were used to evaluate the quality of the evidence among all included studies and data were abstracted and separated by joint—hip, knee and ankle. Descriptive statistics are presented. We identified and included 46 studies (5 hip studies, 22 knee studies and 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 microfracture studies, only 20 of a total of 900 patients followed an early weight-bearing protocol. Given the discrepancy between early and delayed weight-bearing sample sizes available, comparative analyses of outcome scores and complications/reoperations were not pursued. With respect to ankle microfracture studies, there were no differences in functional scores and the rate of complications or reoperations between early and delayed weight-bearing groups. There is insufficient evidence to draw any meaningful conclusions with respect to differences in functional scores between early versus delayed weight-bearing following microfracture surgery for the treatment of chondral lesions in the hip, knee and ankle.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,010 | 0,002 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».