Patient compliance with touchdown weight bearing after microfracture treatment of talar osteochondral lesions.
BACKGROUND
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).


METHODS
Fourteen patients, who had been treated with arthroscopic debridement and microfracture, were followed prospectively. The patients were evaluated for weight bearing compliance with using a stationary gait analysis and feedback system at the postoperative first day, first week, third week, and sixth week.


RESULTS
The mean visual analog scale (VAS) scores of the patients at the preoperative, postoperative first day, first week, third week, and sixth weeks were 5.5, 5.9, 3.6, 0.9, and 0.4, respectively. The decrease in VAS scores were statistically significant (p < 0.0001). First postoperative day revealed a mean value of transmitted weight of 4.08% ±0.8 (one non-compliant patient). The mean value was 4.34% ±0.8 at the first postoperative week (two non-compliant patients), 6.95% ±2.3 at the third postoperative week (eight non-compliant patients), and 10.8% ±4.8 at the sixth postoperative week (11 non-compliant patients). In the analysis of data, we found a negative correlation between VAS scores and transmitted weight (Kendall's tau b = -0.445 and p = 0.0228).


CONCLUSIONS
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. 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.
Department of Orthopaedics and Traumatology, Istanbul University, Istanbul Medical Faculty, Çapa-Fatih, Istanbul, 34093, Turkey. gokhanpolat7@gmail.com.
Gökhan
G
Polat
Department of Orthopaedics and Traumatology, Istanbul University, Istanbul Medical Faculty, Çapa-Fatih, Istanbul, 34093, Turkey.
Gökhan
G
Karademir
Faculty of Science Health Physiotherapy & Rehab. Division, Istanbul University, Istanbul, Turkey.
Ekin
E
Akalan
Department of Orthopaedics and Traumatology, Istanbul University, Istanbul Medical Faculty, Çapa-Fatih, Istanbul, 34093, Turkey.
Mehmet
M
Aşık
Department of Orthopaedics and Traumatology, Istanbul Medipol University, Istanbul, Turkey.
Mehmet
M
Erdil
D000293:Adolescent; D000328:Adult; D054544:Arthroplasty, Subchondral / Q000379:methods / Q000534:rehabilitation*; D001182:Arthroscopy / Q000379:methods; D003646:Debridement / Q000379:methods; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D055034:Osteochondrosis / Q000534:rehabilitation / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain; D010349:Patient Compliance; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D013628:Talus / Q000601:surgery*; D016474:Weight-Bearing / Q000502:physiology*; D055815:Young Adult
Microfracture treatment; Patient compliance; Talar osteochondral lesion; Touchdown weight bearing