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Author Topic: Still pain after 10 months - microfracture  (Read 19166 times)

Offline Bulls23

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Still pain after 10 months - microfracture
« on: August 25, 2008, 07:21:17 PM »
Hi, October last year i had my knee microfractured after the surgeon found a 1x 1 1/2 cm cartilage damage on the lateral femur condyle. Here 10 months later I find that my knee still hurts when I put weight on it. No runing or other sports related activity where impact is required. I'm rehabbing with a lot of cyckling and PT. I'm 34 years old and sports is my life...

The doctor who did the microfracture procedure finds that it is now time to do look inside the knee again and maybe do a new microfracture. Is it to soon?
 
Iím really in doubt whether I should go on with this procedure or keep trying to rehab the knee and hope for the miracle!
 
If any of you, with your knowledge on cartilage repair, give me any kind of advice or input to this dilemma I would be more than thankfull

Kind Regards
 
Carsten Pagh

Offline Nettan

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Re: Still pain after 10 months - microfracture
« Reply #1 on: August 25, 2008, 09:12:53 PM »
Has any Mri been done ? Is the knee hot or swollen or just the pain ?
I understand this is tough to know what to do or not.
Why does the OS want surgery ? Does he believe that microfracture has failed ?
You had any second opinion ?
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline mokeymiddle

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Re: Still pain after 10 months - microfracture
« Reply #2 on: August 25, 2008, 09:45:22 PM »
I don't have a lot of wisdom to offer... I'm just 3 months out from my microfracture.
But my OS and I have talked extensively about "what if it didn't work..."
He says that MRI doesn't really show him what he wants to see and that the only way he can really check to see how a microfracture has healed is with a scope. Also, that swelling near the site tends to be a worse prognostic indicator than pain... and that if I'm having swelling and pain in 6 months (which would put me 9 months past surgery) then he will go in and have a look around... He said in the meantime to expect some pain... to ice as necessary, to get lots of low impact exercise (esp. swimming and bicycle), and to keep my weight down as low as possible (still working on that one).
Not sure if that helps you or not...
Good luck and please let us know what happens!! I know I'm super interested in how other "MFers" are doing!!
-mm

Offline sandiegosteve

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Re: Still pain after 10 months - microfracture
« Reply #3 on: December 16, 2008, 12:16:26 AM »
At 10 months, I was still getting pain.  I didn't have enough muscle balance.

At 12 months, a lot of that pain had gone away.

I'm at 16 months now, and it feels significantly better.

I do a lot of cycling and PT.  I also added swimming with a kickboard at about 12-13 months.  That helped a lot.

For me, I think a lot of it was/is a combination of my desk job and not being 16 anymore.  I am 33 and muscle just doesn't come back as fast as it used to.  When I wold push, I would get swelling.  Now I've built a solid base again and I don't get the swelling any more.

Good luck!
Rt. Knee
- Microfracture on 2 lesions (2.5x2.2 and 2.2x1.0) - July 2007
- Medial Meniscus - July 2007
- Cartilage removal - December 2002

blog on my surgery: http://www.sandiegosteve.info/me/microfracture-surgery/

Offline michelel

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Re: Still pain after 10 months - microfracture
« Reply #4 on: April 05, 2009, 06:30:43 PM »
Hi sorry to hear youre having so much trouble.  I will tell you about my experiance, but everyone is different.  I had MFX 8 months ago and I was in more pain after than I was preop.  Followed all the rules, but I was in agony.  After 4 months of this, my OS ordered an MRI, it should that the MFX had failed there was no growth of cartilage. My defect is MFC 2cm x .5cm.  He referred me to a sports med specialist who does a lot of OATS.  She was very smart and answered all my questions honestly. She also said MFX shouldnt be preformed unless the defect was less that 2cm.  Anyway we talked about all the options ACI, PKR, and OATS.  She stated to me that OATS would be best for me.  SO my surgery date is April 27.  I have done tons of research on OATS, and it sounds good to me.  She is going to take 2, 1cm plugs from the nonweight bearing part of my knee and plug the defect.  The donor site area will be plugged with either the good bone from the defect or some sort of rod, or even TRU fit plugs.  Theres a great website CartilageDoc.org It has info on all the articular cartilage defect, procedures. So I think you definatley need an MRI because it will clearly show if the MFX has failed or not.  Good luck.  And please keep us posted.  Be looking for my post op diary, Im gonna start it as soon after the op as I can.
PEACE & LOVE
Michele
Right Knee:  1983 meniscal tear scope debridment &lateral release. 1991, 1997, 2001
2003 scope meniscal tears. 
8-08 MFX MFC lesion FAILED.
 4-09 Went in for OATS-not a canidate.
 6-09 Uni Right MFC.

Offline ruready3

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Re: Still pain after 10 months - microfracture
« Reply #5 on: April 06, 2009, 10:02:58 PM »
Hi Bulls23, I was in the same boat as you having had 1 failed MFX. Spoke to my doc about Oats and in the end had a revision MFX instead.(I wanted OATS he chose MFX) Now I am 9 months post MFX and still in pain and weightbearing activities are a big challenge. I am amazed at how OS's continue with revision MFX especially when the first failed and the literature out there shows that MFX does not fill in the defect and when it does it is a less durable cartilage. Unfortunately we have to be our own docs. Do your research and talk to folks who have been through it. It is not a conincidence that there are so many stories like ours. I agree with Michele, Oats procedure looks promising. Let us know how it goes...

     

Offline Tom Footballer

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Re: Still pain after 10 months - microfracture
« Reply #6 on: May 01, 2009, 03:41:38 PM »
Hi I'm worried by what you say here. Did you trip or fall in the first few weeks after your surgery?

I've had problems due to the scenario below and wondered if it match your story? ;

3 weeks post microfracture operation, to regenerate cartilage growth following a football injury,  I fell and hurt my knee again.

I stumbled/slipped on my crutches putting my injured leg down and slid along a wet pavement. The knee swelled up and I had the same feeling in the knee that I experienced before the microfracture operation.

It has been 5 days since this incident and the stiffness hasn't gone. I am worried that I may have reversed all the hard work post operation by affecting in some way the scar tissue/new cartilage.

Any advise of what this means, or info from anyone else who has had a similar setback would be much appreciated. My PT seemed to shrug off the incident and remarked that the swelling wasn't to bad, but I'm worried as the knee feels similar to what it did before my operation i.e. stiff/ swollen.

Many Thanks   

Offline Artica

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Re: Still pain after 10 months - microfracture
« Reply #7 on: May 16, 2009, 02:50:10 PM »
Some very interesting posts.  Seems to confirm where I am right now with my knee and why I'm indecisive of how to move forward.  Ruready made some good points about Mfx which is what the  literature seems to be showing.  "May not fill in the defect and is a less durable cartilidge"  My Dr. told me Mfx success rate is 50%.  Thats very low to me to be messing around with that choice of surgery and having to wait 6 months to a year to see how the cartilidge filled in.  And then worrying about in 2 to 3 years would the fibrocartilidge break down.  My Dr. had more enthusiam about OATS surgery the success rate seems to be more in the 75% to 80% range.  But I'm still doing research on OATS surgery and pros and cons to that.  Michelel please keep me updated on your thoughts and progress with that as i'm considering having my dr. go with that surgery as opposed to Mfx.  I'm very interested in hearing how your OATS surgery went on April 27 and your  current recovery.   My OCD is 2.3 cm x 1.8cm lateral femoral condyle 4mm depression.  SandiegoSteve  Interesting how at 10 months you were still feeling pain and then 12 to 16 months alot of the pain went away and now feeling significantly better.  I wonder if my recovery would be along the same time path being I'm 33.  If you could do it again would you have done Mfx surgery or would you have went with the OATS surgery.  That seems to be the decision I have to make.  I don't know the size of your defect.  I think being my defect is 2.3 cm just slightly over 2cm is size may be steering away from mfx too.  If say it was 1.5 cm x 1.5cm I'd probably have to have mfx done.  I'd also be very interested to hear how Mokeymiddle and Bulls23 are doing now after posting back in August about 10 months later.  Good luck everyone with your recovery!

Offline sandiegosteve

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Re: Still pain after 10 months - microfracture
« Reply #8 on: May 24, 2009, 11:36:11 PM »
SandiegoSteve† Interesting how at 10 months you were still feeling pain and then 12 to 16 months alot of the pain went away and now feeling significantly better.† I wonder if my recovery would be along the same time path being I'm 33.† If you could do it again would you have done Mfx surgery or would you have went with the OATS surgery.

Yes, OATS vs MFX was a question.  We even took a biopsy to grow in the lab in case mine failed.  My surgeon, Dr. Behr, told me that the numbers/results between the two point to better results with MFX.  Both are relatively new in medical terms, so there isn't error proof data to go off yet.

At close to 2 years since my procedure, things are going very well.  Yea, I get some discomfort for the first step or two after I've been sitting for a while.  But I'm riding hard and chasing the kids around ok.  I was never a runner and my Dr. suggested I don't become one.  I'm ok with that.
Rt. Knee
- Microfracture on 2 lesions (2.5x2.2 and 2.2x1.0) - July 2007
- Medial Meniscus - July 2007
- Cartilage removal - December 2002

blog on my surgery: http://www.sandiegosteve.info/me/microfracture-surgery/

Offline Stevie7

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Re: Still pain after 10 months - microfracture
« Reply #9 on: May 27, 2009, 11:46:49 PM »
My story is this. Had MRI scan Feb 2009 and was told by my surgeon that I had torn cartilage and required to have menisectomy and microfracture to lateral femoral condyle of left knee. Op carried out in March 2009, initially NWB with complete use of crutches for 6 weeks. At 6 week consultation still in a lot of pain, unable to weight bear,extremely stiff, knee sticks and releases with audible and painful click and would give way if I was standing on it. Toothache feeling in knee, throbbing continually especially when seated for a period of time and still swollen. NWB extended for further 5 weeks and have had consultation today. Symptoms still remain.Surgeon has told me to begin rigorous physio and to gradually get myself off the crutches as the pain allows. Problem is that knee is too painful to do much with at the moment. Am I being impatient or is this how I should expect to feel? Surgeon isnt very forthcoming with information and I get the impression he is not telling me all of the facts and trying to keep me positive. Does anyone else have a similar situation? Is this normal? How long willit take for the pain to subside? Can anyone who has had this op please offer some advice or information please, Im starting to feel down about all of this

Offline sandiegosteve

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Re: Still pain after 10 months - microfracture
« Reply #10 on: May 28, 2009, 01:08:18 AM »
My story is this. Had MRI scan Feb 2009 and was told by my surgeon that I had torn cartilage and required to have menisectomy and microfracture to lateral femoral condyle of left knee. Op carried out in March 2009, initially NWB with complete use of crutches for 6 weeks. At 6 week consultation still in a lot of pain, unable to weight bear,extremely stiff, knee sticks and releases with audible and painful click and would give way if I was standing on it. Toothache feeling in knee, throbbing continually especially when seated for a period of time and still swollen. NWB extended for further 5 weeks and have had consultation today. Symptoms still remain.Surgeon has told me to begin rigorous physio and to gradually get myself off the crutches as the pain allows. Problem is that knee is too painful to do much with at the moment. Am I being impatient or is this how I should expect to feel? Surgeon isnt very forthcoming with information and I get the impression he is not telling me all of the facts and trying to keep me positive. Does anyone else have a similar situation? Is this normal? How long willit take for the pain to subside? Can anyone who has had this op please offer some advice or information please, Im starting to feel down about all of this

6 weeks of non weight bearing will make you stiff and put you  in a lot of pain.  It could be the fact that you have tight tendons and weak muscles (that causes grinding).  Going from NWB to walking is not a flip of the switch.  I was at PT 3 times a week and I'm athletic to start with.  It took a sold week to get to 1 crutch, and then longer to get off crutches. 

Do a lot of flexibility and basic exercises and expect to take it a while.  It is hard work.  I often wondered if it was worth it... now I do say it was.

You will feel down.  It sucks.

When your muscles and tendons are not in balance, it makes the knee lock up and grind, that causes swelling.  A painful cycle that is fixed with the right exercises.  I was close to 9 months if not a year before I had the strength to carry my kids even though I could walk ok with just my weight.

Rt. Knee
- Microfracture on 2 lesions (2.5x2.2 and 2.2x1.0) - July 2007
- Medial Meniscus - July 2007
- Cartilage removal - December 2002

blog on my surgery: http://www.sandiegosteve.info/me/microfracture-surgery/

Offline bikesplosion

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Re: Still pain after 10 months - microfracture
« Reply #11 on: August 06, 2009, 06:20:25 PM »
I am almost 2 weeks post microfracture and I still have plenty of pain and stiffness (which is to be expected from what I've been reading in the forums).

My concern is that my doctor did not prescribe the use of a CPM machine at all. Just leg exercises 4 times a day, and 10 minutes of stationary bike, gradullay increasing to an hour over time.

Has anyone else had microfracture WITHOUT CPM??? I haven't read a single case, and I'm about to call my doctor's office to ask if this was a mistake or if that is his post-op routine. He is a preeminent cartilage  specialist with stellar credentials, but who knows, maybe someone screwed up?!

Any input is apprecited. Thanks!

Offline Scooter72

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Re: Still pain after 10 months - microfracture
« Reply #12 on: August 06, 2009, 10:37:32 PM »
I am almost 2 weeks post microfracture and I still have plenty of pain and stiffness (which is to be expected from what I've been reading in the forums).

My concern is that my doctor did not prescribe the use of a CPM machine at all. Just leg exercises 4 times a day, and 10 minutes of stationary bike, gradullay increasing to an hour over time.

Has anyone else had microfracture WITHOUT CPM??? I haven't read a single case, and I'm about to call my doctor's office to ask if this was a mistake or if that is his post-op routine. He is a preeminent cartilage† specialist with stellar credentials, but who knows, maybe someone screwed up?!

Any input is apprecited. Thanks!

I am 6 weeks post mfx in the trochlear groove of my left knee.  I was weight bearing after the surgery but told not to bend my knee, as much as I can help it, for the first 6 weeks. (Strangely enough, my OS didn't want to prescribe me a brace) 

But to the point.. no CPM for me.  I even asked him about it a few times before and after the surgery. 

If you want to read more of my experience, I have a thread in this forum. 

Offline PieceDesigner

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Re: Still pain after 10 months - microfracture
« Reply #13 on: August 07, 2009, 05:05:02 AM »
Where was your microfracture? Weight bearing?

I had microfracture on a weight bearing spot, and also at the same time on a non-weightbearing spot.  I was not given a CPM unit.  I was given gentle exercises to do 3 times a day (heel slides, ankle rolls, working on 90 degree bends, and working on touching back of knee to bed while lying down).  That was all for 5 weeks. I'm at 6 weeks now.

Nan

Offline stgiles16

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Re: Still pain after 10 months - microfracture
« Reply #14 on: August 07, 2009, 05:37:32 AM »
I have had 2 microfractures (first one failed, second one now wearing out). after my microfractures, i hurt for around 9 months to a year before i started to feel "normal".  I am supposed to call my OS and make an appt to see about allograft surgery . I think my last micro was 5 or 6 yrs agoso it lasted a pretty good while. I am now looking for a PERMANENT fix.
good luck
missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

 















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