Microfracture Knee Surgery

do search the dbase/forum as there have been several excellent threads on microfracture surgery including several links to sites describing recovery etc. BUT its 6 wks complete nonweight bearing---thats the standard everywhere

I had microfracture surgery done. The success rate is about 80% in that about 80% are eventually better than they were before the surgery, but the surgery is rarely a 100% success such as you find with meniscus surgery.

However, can you return to serious distance running again, probably not. Many football and basketball players have had it done and only about 20% of them ever make it back. Famous ones are Jason Kidd and Stotomyer, but it took sto about 2 years before he really returned. Kidd was extremely lucky and rare and he was competing again only 10 months after the surgery. Reggie Bush just had it. I would be shocked if he really makes it back.

You are supposed to be totally non-weight bearing for 6-8 weeks or it won't be successful. You cannot put your foot on the ground at all. Also you should be doing CPM for 6 weeks and you must really work on getting range of motion back so you don't get scar tissue which will create a worse problem than your initial problem. Microfracture results in massive bleeding in the knee and great risk of scar tissue. You need to ice the hell out of it and keep it elevated most of the day. The quicker you get rid of swelling the less chance of scar tissue.

After the 6-8 weeks you can start walking on it. It takes several more months for significant improvement, you will feel pain most of the time and have frequent bouts of swelling and will consider the surgery a failure but you won't know for sure for several more months. Complete healing takes about 1 year although some people continue to improve up to 2 years and I was one of those people.

Everything depends on where your lesion is. If it is in a weightbearing area, you have to be non-weightbearing for 6 weeks, and might have difficulty ever running again, but if it is not then you don't have to be non-weightbearing, you just have to be careful not to bend your knee too much. I just had microfracture in a non weight-bearing area 3.5 weeks ago, and I am walking around just fine, although I still have to ice a lot. Any sort of running is still a couple months away, but I'm hopeful. Recovery also depends how big your lesion is I think, and mine is pretty small.

not necessarily wrote:

Everything depends on where your lesion is. If it is in a weightbearing area, you have to be non-weightbearing for 6 weeks, and might have difficulty ever running again, but if it is not then you don't have to be non-weightbearing, you just have to be careful not to bend your knee too much. I just had microfracture in a non weight-bearing area 3.5 weeks ago, and I am walking around just fine, although I still have to ice a lot. Any sort of running is still a couple months away, but I'm hopeful. Recovery also depends how big your lesion is I think, and mine is pretty small.

When you say non-weight bearing, do you mean like behind the patella? I am just curious as to which areas in the knee are considered weight bearing. Thanks

Well basically I'm screwed. Because of events out of my control I have been putting weight on my knee since around the 5th day. I had my surgery on March 5th and I feel fine other than swelling. But I guess since I have had to put weight on it my surgery is already a failure.And at age 37 my running is basically over. What a mess I probaly would have been better off if I had only had the meniscus tear surgery. I did not know before hand the Doctor would do a Microfracture procedure. I guess once he looked inside my knee he saw some damage under my femur. He then did the micro procedure.

I think behind the patella and the trochlear groove area are non-weight bearing. My microfracture was in the trochlear groove. Check with your dr. to see if your microfracture is in a weight bearing area or not. I think protocols vary a lot depending on the doctor, for instance I don't have a CPM machine either, as my doctor said they didn't help with the area I had a microfracture on.

Don't assume you are screwed. Talk to your doctor; it sounds like you need to do more of that. Why would you not find out as much as possible about this from your doctor?

Would you pay a mechanic who fixed your car without knowing what he fixed? Your body is much more important than your car.

Put your health over work man, you gotta deal with that knee for the rest of your life regardless of if you ever run again.

Talk to your job, I'm sure they can compromise while you get better. If not and they fire you or something you probably have a killer lawsuit on your hands.

Yeah I'm not going to go back to work until Doctor say's it is ok. I have a 3 year old and a 1 year old at home. It is difficult to use the crutches 24/7 because of family needs. I'm going to try and stay on the crutches as much as I can. All I can do is hope for the best and in time hope to run again at the level I did before.

Knee Surgery, if this procedure does not work out for you there are other options besides microfracture. My dad has had bone on bone in his knees for years and he had a procedure done that has helped him quite a bit called platelet rich plasma injections. Here is the website for the guy that did his, although there are probably getting to be quite a few others docs that do this as well.

http://www.craneclinic.com/

One critical thing I forgot to mention was make sure you are taking glucosimine and condroitin. You should be taking double strength dose 3 x per day. The cheapest is available at Wal-Mart. This will greatly increase the odds of your success.

microfracture stimulates the formation of "fibro cartilage" to fill in the hole where there was once "hyaline" cartilage. Glucosimine/condroitin does the same thing, stimulates the growth of fibro cartilage just as microfracture surgery does, so you will essentually double your chances for success.

Also, fibro cartilage isn't as good as hyaline cartilage and eventually wears out, so you need to keep taking the glucosimine/condroitin for the rest of your life to constantly keep regenerating the fibro cartilage as it wears out. That is a small price to pay.

You MUST get rid of the swelling as quickly as possible, that means total non weight bearing on crutches as much as possible. It means having your knee elevated above your heart as much as possible. It means icing the hell out of it as much as possible. Swelling is the mother of scar tissue and if you get scar tissue you are looking at mutiple more surgeries like happened to Patriot QB Tom Brady. Get that swelling out of there. It usually takes a long time after microfracture which is very tramautic to the knee

If you have a desk job, go back to work immedaitely but use crutches and elevate and ice while at work. It will be a huge hassle and people will laugh at you, but your bosses will appreciate you being there and you keep your job. Your job and providing for your family is very important and so is your knee as another guy pointed out, you will live with this knee for the rest of your life.

Yeah, that form you sign before surgery allows them to do stuff like microfracture without telling you in advance. Also docs like to do it because any joe blow doc can do it, it is just simply drilling 3 small holes into the bone where the cartialge defect is which causes massive bleeding and eventually a sort of scab forms an eventually turns into fibro cartilage over many months.

If under your kneecap or trochlea it is technically "non-weight bearing". However about half the docs will still say total non-weightbearing, while others won't. The guy who claims to have invented it, Steadman in Denver say always total non-weight bearing. Who is right? I am not sure. The theory is if you weight bear the forces of patella rubbing across the trochlea will cause the scab to fall off and void the surgery. Is this true? I am not sure.

One thing I am 100% positive. Take glucosimine and condroitin and the defect will get filled in again with fibro cartilage even if you took off the scab by early weight bearning.

apply liberally wrote:

Knee Surgery, if this procedure does not work out for you there are other options besides microfracture. My dad has had bone on bone in his knees for years and he had a procedure done that has helped him quite a bit called platelet rich plasma injections. Here is the website for the guy that did his, although there are probably getting to be quite a few others docs that do this as well.

http://www.craneclinic.com/

Is this the same as the silicone knee injections? Because that is a option that I will go with after my rehab if knee is still bad. Thank's for the helpfull info it has given me hope!!!!!

I am not familiar with the silicon injections, but I think this would be different. This procedure involves taking out blood and spinning down the plasma to very concentrated levels and then re-injecting it to stimulate healing. For more serious knee problems they go one step further and I think the procedure removing fat cells and putting them in place of the cartilage where they can help regrow cartilage. This method works better but is a little more involved, and I think may involve some incisions, although I am not too certain about the details. I do know though that both procedures are pretty non-invasive and although you aren't supposed to run for a few weeks after, you can walk around. The more you rest though, the more chance the cartilage has to grow.

This seems to be a pretty legit method of cartilage regrowth. I had hip surgery a year ago for a labral tear, and my surgeon, who is one of the top hip docs in the country, used this in my hip which is now completely better. He is also going to use is to treat some tendonosis I have in my knee. He seems to really think it works, and I am a big believer in it as well, hopefully you can locate somewhere to get it done if you indeed need additionally work done.

I had microfracture surgery in August 2006. My leg was in an immobilizing brace for 6 weeks and on crutches. I was also supposed to use a machine that slowly bent my leg for 6 hours a day (can't remember what the machine was called). But I could only stand using it for 2-3 hours because of the boredom. When I got the brace off I would have been happy just to walk normally again, running wasn't even on the radar screen. But little by little it got better. I did my first run of 200m (yes, just 200m) about 8 weeks after the surgery. I built up very slowly from there, but after awhile I was completely pain free. Since then I've run as far as 18 miles on trails, did a half marathon in 1:29, and beat a pile of college kids in a 5k this morning. Things may look bleak now but if you let it heal there's a good chance you'll be OK.

Make sure you take Glucosamine-Chondroitin-MSM, it seems to help a lot. Also, be careful about twisting your knee. Bedroom Olympics will probably be more dangerous than running in that regard. Good luck!

I had it 7 months ago. My situation was similar: I went in for a scope and woke up with microfracture!! I did not plan for crutches and time off work either, so I feel your pain! I would say that you can work if you can use your crutches at work. I am a teacher and found it too difficult to try and teach on crutches. I was able to go places and do things, but followed the dr.'s orders to a T. As long as you keep the weight off of it, you should be OK, but I would wait as long as possible before returning, just to be safe.

Same story, went in for a scope, woke up with microfracture.

it took forever to get back to walking, muchless running.

I did heal up well, eventually got back in shape and Ive run 5 marathons since the surgery and lots of miles.

I have the same story, went in for partially torn lateral meniscus, came out with medial femur microfracture. I was no weight bearing for 4+ weeks, and stayed home from work, laid on couch most of the time, used CPM for 3 weeks, and do exercises on my own now, flexion and extention of knee, abduction and adduction of the leg, calf extensions. Went back to work, stayed mostly non-weight bearing, but am not progressing to very lite foot to ground while using crutches. I have a long distance from car to office so it makes that trip a little easier, but I dont take a step without my crutches. I have a small amount of swelling when the m-fx took place, but it goes down a bit each day. I have darn near full ROM(compared to good knee). I am going to start taking some glucosamine(a few people said that might help), cant hurt I guess. I see my doc every other week. See him again at 6 weeks recovery, said we could start PT if I can be somewhat weight bearing w/out pain. I think I am doing okay, little pain, its more of a mild discomfort at times. My shoulders, chest and triceps are huge now from crutching everywhere!!! I dont ice as much as I should, btu I try to keep it up. Doc said everything looked okay, but not much to tell from looking.

Good luck everyone. It sure sucked waking up to 6 weeks of crutches. But if 6-8 weeks of barely moving means 30-40 years without as much knee pain, I'll do it.

How about bking after microfracture? is this much better for you than running or is it still problematic?

Very prominent ortho here in CT offered to do micro surgery on my knee but claimed he wouldn't do it if I even thought about running again.