{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T14:42:05Z","timestamp":1790433725305,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,10,6]],"date-time":"2020-10-06T00:00:00Z","timestamp":1601942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,10,6]],"date-time":"2020-10-06T00:00:00Z","timestamp":1601942400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,10,6]],"date-time":"2020-10-06T00:00:00Z","timestamp":1601942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To determine whether the use of an unloading brace can increase the thickness of cartilage regenerate after microfracture surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a randomized (1:1) controlled clinical trial. Twenty\u2010four patients who underwent microfracture between 2012 and 2015 were identified and were randomly assigned to an unloading brace group or a no\u2010brace group. All patients were kept non\u2010weight bearing for the first eight weeks after surgery and then patients in the intervention group began using an unloading brace for an average of 63.9 (SD\u2009=\u200941.6) days to protect clot stability by exerting a varus or valgus force on the knee to decrease the force on the knee\u2019s lateral or medial compartment, respectively. Quality of the cartilage repair was assessed with knee magnetic resonance imaging to determine repair tissue thickness (primary outcome), repair tissue volume, and T2 relaxation times at 12 and 24\u00a0months after surgery. Clinical outcomes were evaluated with KOOS, Tegner, SF12, and Lysholm questionnaires at six, 12 and 24\u00a0months after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three patients were lost to follow\u2010up, resulting in 21 patients ultimately analyzed. The unloading brace repair tissue was greater than the no\u2010brace group in volume (26.8\u2009\u00b1\u200923.7\u00a0mm<jats:sup>3<\/jats:sup> vs \u2212\u20098.4\u2009\u00b1\u200922.7\u00a0mm<jats:sup>3<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009=\u20090.005) and thickness (0.2\u2009\u00b1\u20090.2\u00a0mm versus \u2212\u20090.4\u2009\u00b1\u20090.3\u00a0mm, <jats:italic>p<\/jats:italic>\u2009=\u20090.001) at 12\u00a0months and in cartilage thickness in the unloading brace group at 24\u00a0months (0.4\u2009\u00b1\u20090.4\u00a0mm versus \u2212\u20090.1\u2009\u00b1\u20090.3\u00a0mm, <jats:italic>p<\/jats:italic>\u2009=\u20090.029). There was a positive correlation between wearing the brace longer and improved 6\u2010month KOOS symptom scores (<jats:italic>r<\/jats:italic>\u2009=\u20090.82, <jats:italic>p<\/jats:italic>\u2009=\u20090.013), 6\u2010month KOOS QOL scores (<jats:italic>r<\/jats:italic>\u2009=\u20090.80, <jats:italic>p<\/jats:italic>\u2009=\u20090.017), 6\u2010month Tegner scores (<jats:italic>r<\/jats:italic>\u2009=\u20090.94, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), and Tegner score changes from baseline to 6\u00a0months (<jats:italic>r<\/jats:italic>\u2009=\u20090.80, <jats:italic>p<\/jats:italic>\u2009=\u20090.032).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study found a significant mid\u2010term increase in cartilage repair tissue thickness following unloading bracing in patients recovering from microfracture for isolated chondral defects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>II.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-020-06228-6","type":"journal-article","created":{"date-parts":[[2020,10,6]],"date-time":"2020-10-06T20:02:37Z","timestamp":1602014557000},"page":"2889-2898","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effects of unloader bracing on clinical outcomes and articular cartilage regeneration following microfracture of isolated chondral defects: a randomized trial"],"prefix":"10.1002","volume":"29","author":[{"given":"Jaclyn A.","family":"Konopka","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Stanford University Medical Center 450 Broadway, MC 6342 94063 Redwood City CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea K.","family":"Finlay","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Stanford University Medical Center 450 Broadway, MC 6342 94063 Redwood City CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Eckstein","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Institute of Anatomy Paracelsus Medical University Salzburg Austria"},{"name":"<!--<label>3<\/label>--> Chondrometrics GmbH Ainring Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason L.","family":"Dragoo","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Stanford University Medical Center 450 Broadway, MC 6342 94063 Redwood City CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,6]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102020\u2010217363"},{"key":"e_1_2_8_3_2","doi-asserted-by":"crossref","unstructured":"BrinkhofS Te MollerN FroelingM BrommerH vanWeerenR ItoKet al. 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