4 months post microfracture...has it failed?

[jt10]

Hello,

I am just over 4 months post op from microfracture to a load bearing area of the med. femoral condyle. I have been having a hard time lately with pain, swelling and a snapping/clunking when I bend my knee. My OS isn’t very helpful so I thought I’d put my questions out to the mfx community here.

I know it hasn’t been all that long since my surgery but I don’t seem to be able to move forward in my rehab because of this pain and swelling. The physio says that by now I should be able to walk up and down stairs and do the balance board with my knee bent, but when my knee is loaded and I try to bend it I get a very sharp hot pain in the area that was mfx’d. The knee also aches at rest and feels heavy, and I often have night pain that keeps me awake so I am not getting the rest I need. Does this sound familiar to anyone?

I am wondering at what stage a mfx is determined to be a failure and what criteria are used….scope, MRI ? Is it possible to determine at this stage if it has worked or not, or is it too early? I know I have to be patient but this pain is really wearing me down. I have followed the post op rehab protocol to a T so I am feeling really disappointed with how things are going.

I had put so much hope in this surgery. I am trying to remain positive but it’s hard at times. I’d appreciate any advice, support or ideas that anyone has.

Thanks

[Stevie7]

Hi,

Sorry to hear that youre struggling. If its any consolation, Im 3 months post op microfracture to lateral femoral condyle and have the same painful symptoms as yourself. I feel as if Ive got constant toothache in  my knee as well as all of your symptoms. When my knee locks and releases with an audible clunk its very painful and if Im standing on it - Im going down!!

Ive encountered a very dismissive attitude from my surgeon. Hes got his money - who cares? Ive been at physio since the op doing exactly as they tell me but am not moving forward, still need to use crutches intermittently to move around, its just too sore to walk on at times. Stairs are one at a time. Whether Im walking or sitting the knee justs throbs away around the area that the work was done. If I put my foot down in the wrong place Im in orbit.

Im very doubtful now about the success of the op and would only like to know what the future holds. Maybe its too early to tell?? I hope I havent disheartened you but just wanted you to know that youre not on your own with this one.

Please keep me posted with your progress.

Anybody else got any info or advice???

[jt10]

Hi Stevie7,

Thanks for your reply and no, you haven't disheartened me. While I wouldn't wish this on anyone it's good to know I'm not going through it alone. Sometimes it can feel very lonely....

BTW, your description of the pain as a toothache is spot on. I was struggling to find a good way to describe it but couldn't think of the right word. Thanks!!

Good luck...keep me posted and I will do the same!

[caroline889]

Hi JT

I'm 7 wks post op microfracture both knees and still have the same pain under the knee cap which I had before the op. When are you due to see your OS again? From what I've read on here, recovery times can vary with some people taking up to a year before the pain goes away so there is still a chance that yours will work. Good luck

[madel23]

I'm 3.5 months out from mfx and still feeling pain.  Although mine was to the trochlear groove, so I didn't have a non-weight bearing phase.  I'm hoping I'm just a slow healer as opposed to a non-healer, but starting to get worried...hang in there everyone!

[ghost]

Hi,
I'm 6 months post op for a mfx of the trochlear groove.  I still can't walk long distances, it aches if I leave the knee bent for too long and I can sort of go up stairs, but not down.  My os told me that the mfx failed and there are still areas with no cartilage fill.  So on 7/21 I'm off for the 4th surgery in 19 months and will be doing a patellofemoral resurfacing.  I concede, give me shiny new parts and let me get on with my life.

Hope everyone starts to see some improvement.  The one thing we all know is that this surgery is as much of a mental challenge as a physical one with random pains and aches that come out of no where and for no reason.  FYI, I'm with you, if I put my foot down the wrong way it's a one way ticket to mars.

Ghost

[caroline889]

Good luck Ghost with your surgery - hope it works out for you this time. I feel sorry for you.  Hope everyone else's microfractures are successful! At least with other  procedures you more or less know if it has worked or not. I find this microfracture business torture! Just waiting and waiting. I had  2 knees done. My left has very little pain  but my right is very painful. I'm only 7 wks  yet but can't help thinking my right has failed. Waking up every morning and asking yourself  how is it today  it does your head in!

Keep us posted

Caroline

[ghost]

Hi,

I'll keep everyone posted on how it goes.  I completely understand that feeling of did it work.  Microfracture is a mental roller coaster.  Even now at 6 months out I keep hoping there will be some improvement so every day I try to do something that I wasn't able to do 2 days ago.  Sometimes it works but most of the time it doesn't.  I guess that's just my way of dealing with another surgery, just holding out hope that I'll get up one morning and things will have magically improved.  I have to admit that I have seen steady improvement, the problem is that there is one area where no cartilage grew so if I don't baby that area I can go from 0-10 on the pain scale in a heartbeat.

Good Luck!  I hope you start to see some improvements.

Sue

[jt10]

Hi everyone and thanks for sharing your stories and words of encouragement.

Describing mfx as a mental roller coaster was perfect! It's hard to stay positive sometimes when things are so unpredictable....but I'm trying! I'm not seeing the OS again until 22 June so I will just have to keep working hard at rehab until then.

Ghost - at what stage did the OS tell you that the mfx had failed? Did he do an MRI or was it based on your symptoms?

Caroline889 - I cannot even imagine having this done to both knees. You are extremely brave...and strong!

Finding this forum has been a lifesaver. I feel much better now that I have read other people's stories. This recovery process has been difficult so far and there are very few people I feel I can talk to. Friends keep asking me when I'll be up and running again and don't understand my limitations and this whole process has put a great deal of strain on my relationship. My husband thinks I should be able to do all the activities that I used to do by now and it has affected us quite a lot.

I now feel reassured that I am not alone and that my recovery process is not abnormal. I will just try to be patient and take each day as it comes.

thanks and good luck to all of you!

[ghost]

Hi,

I was told about the failure when I went back for my 5 month post op visit on May 11th.  Although I admit that I had a pretty good idea before the appt that things weren't progressing as they should.  I had/have a wonderful PT person who had pretty much sat me down at about the 4 month mark and told me that I should be able to do stairs and squats etc with relative ease.  I obviously couldn't do those things and a couple of weeks before my OS appt he told me he was pretty sure that I would need a partial knee replacement.  As for the os, he asked about what I could and couldn't do and then just moved my leg while pushing down on the patella and you could hear, feel and see the patella taking a nosedive into the area where there was no cartilage fill and he immediately said we need to do another surgery asap before more arthitis and scarring develops.  He recommended either OATS or PFR.  I talked to him about both options and decided after 3 surgeries in 12 months and a failed MFX I was done trying to make the body produce new cartilage, when I combined that with the fact that OATS, if it worked would probably only buy me another 5 years I decided to opt for PRF as it is a more long term solution and should last at least 8 years and possibly for 10 or more years.

I hope that you continue to see some improvement.  It is a slow process with random pains coming out of no where.  You can do something as simple as getting tangled in the blankets at night or catch your foot on the edge of a stair and it sends you into orbit.  That bone stays sore for a long time.  Mine is still getting better, but there are times where I could cheerfully perform my own patellaectomy.

Keep Me posted on how you're doing.

Sue

[jt10]

Hi all,

Well, I haven't had much improvement lately but I'm seeing the OS on Monday which will be my 5 month post op appointment. I hope he can offer some reassurance and/or reasons why I seem to be stuck where I am.

I was just wondering if anyone has advice about questions I should ask the doctor on Monday. I'm trying to get prepared and make a list. The appointments tend to be short and I often feel rushed so it helps if I'm well prepared with questions.

Have a great weekend everybody!

Janet

[ski-bum]

Janet-
How was your appt. with your OS today?  Hopefully good news!!!!!   Is your OS a cartilage specialist? 

What kind of rehab have you been doing lately?  Aggressive of gentle?

I'm about 3 months now and still struggling...

Marc

[jt10]

Hi Marc,

Thanks for checking in. I'm afraid my appointment didn't go too well. The doc said that it is "quite likely" that the mfx has failed given my symptoms and inability to move forward with things like stairs etc.

He said to give it another month, be patient and keep working hard at physio ( we've all heard this haven't we). If I am still having the same problems in one month then he said that would indicate failure of the mfx. 

I am feeling a bit low after getting this news.

Interestingly my doctor just came back from a cartilage repair convention in Miami and he said that every doctor who was there believes strongly in their chosen technique ( MFX, OATS, ACI etc) and there is no clinical evidence that one technique is better than the others. Judging from the messages on this board it seems like there are a lot of people with failed mfx's out there so I don't know what to believe!

I have been following your post and I know you are struggling. I'm so sorry that things are not going well for you and I hope I haven't brought you down with me. Every situation is different!

Oh,and to answer your question about my rehab.....I do about 30 minutes of cycling a day plus wall squats, and at physio I do the leg press machine, hamstring machine and various balance board exercises. I don't know how that compares to what other people are doing.

Thanks again for your message. Keep me posted on how you are doing. I hope things will improve and that you will be one of the success stories. Hang in there....
-Janet

[ski-bum]

Janet

I am SOOOO sorry to hear about the news from your OS.  I appreciate the incredible amount of both physical and emotional energy put into this surgery and to have it fail is devastating!!!  You just want to cry, scream "why me?" or sit at home and give up. 

Now that we have put that behind us we must move forward!!!!!!  Grieve for a short while but when we're done we have to step back into the ring and take another stab at it.  This life is not a dress rehearsal, so you've got to make the best of what life has delivered. 

Research, Question, and decided what to do to heal yourself. 

I so feel what you are feeling.  It hurts.  And this little pep talk is what I keep on telling myself as I prepare for a possible failure. 

This has been the most challenging experience I have had to endure.  It has put strains on my marriage (mostly because of my saddness ) and I've been less productive at work.  I have learned a lot about myself and realized that I have some strengthening to do.

Don't give up.  One more month might be all you need!  Keep me in the loop!

Marc

[jt10]

Hi again Marc,

Thanks for your kind words. I won't give up.

 I'm going to keep working hard until they tell me definitively that the mfx is a failure. If it has failed then it's on to plan B ( whatever that turns out to be). My doctor said that if I need a second surgery I should go to the US, but I live in Switzerland and I don't see how that would work financially or logistically . I have read stories on this board where people had pain for nearly a year and then things seem to improve so I remain hopeful that things could still turn around!!!

You said that this has been one of the most challenging things you've been through and that it has affected your marriage and I know exactly what you mean. It's hard not to feel sad when you are in constant pain and not able to do simple daily activities, let alone sports and things you previously enjoyed. That sadness is hard for our spouses to deal with as there is really nothing they can do to cheer us up.

 I think that is why this board is so valuable to me because I know the people on here really understand what this feels like. It's been great for me to have a place to vent and to read about what others are going through. I feel a lot less alone in all this.

Thanks again for your support. It really does help.
-Janet