Marathoner - 1st microfracture surgery

[rwwerd]

7 days.... 28/M

Hello everyone, I recently had microfracture on the left lateral side of my knee.  This has been giving me problems running and working out for approximately 3 years now.  I decided to go have an MRI done a couple of weeks ago by one of the specialist OS in my area.  After reviewing my prior MRI and this current one, he decided that I needed to move forward with the microfracture surgery.  I did not know what to expect but I trusted his judgement that this was the best option for my full recovery.  The surgery took place on Thursday, October 6th, 2011 and went off without a hitch.  As I was awoke from anesthesia I was given some pain medication through my IV to help me feel better for the ride home.  I wais in a full immobilizer brace and wheeled out in a wheel chair to the car.  For the past 6 days I have been getting better and better each day but the OS told me no weight bearing for the next 6-10 weeks.  They ended up doing a total of 4 microfractures and removing 25% of my meniscus.  I have since gone to physical therapy 2x and we are currently just working on getting the swelling down, stretching and quad strengthening through exercises and E-stim.  I am doing majority of these exercises at home so I have been better prepared than most.  At home I have been icing every hour on the hour to work on the swelling.  As of today I am finally able to see the outline of my patella so the ice is working.  I am hoping to follow through with the schedule that has been laid out for me and return to a full recovery.  My goal is to be running again in 6 months and to start training for my first triathlon, to be completed by next summer.  I plan on posting every week to keep track of my full recovery and rehab.  If anyone has any questions about this surgery please feel free to write under this post. 

[kittent1211]

I had MFX done about 6 years ago.  My doctor told me that I can never run or jump again and I'm not even supposed to walk a lot...no tredmill at all.  Only low impact activities like riding my bike, swimming and I can use the olyptical machine at the gym.  He said every step I take is moving me closer to Total Knee Replacement.  The artificial cartlidge is much more fragile then the original cartlidge that we're born with. 

[rwwerd]

Thank you for your response.  I was wondering where you had your lesions that they had to microfracture?  My OS said that since mine were localized to the lateral side of my knee that I had a 90% chance of being able to return to all of my previous sport activities because of weight distribution. Typically you don't have as much impact or pressure on the lateral side of your knee when running, biking, etc.

I will keep you posted on my recovery and hopefully things will go well.  I am sorry about your outcome possibly being a TKR....I have an uncle that has had both hips and both knees.  He actually gets around pretty good so hopefully with all of the advancements in medicine by the time you need it you will be able to be more active.  Best of luck!

[rwwerd]

1 week + 1 day....

Today I went back to the OS for my checkup.  My knee is healing well and the swelling has gone down approximately 65-75%.  I have most of my ROM back and otherwise and feeling pretty good.  I had my stitches taken out today and had the entire area cleaned.  I no longer have to sleep in a full immobilizer brace, or wear my compression socks.  The OS wants to see me back in 5 weeks to re-evaulate where I am and whether it's safe to walk.  The OS told me going forward with training that I probably should give up running marathons because of the wear and tear it takes on my knee.  He told me that I can run, but that it greatly increases my chances of having to come back in 3 years and have this done again.  I was not quite ready for that news but you have to take it as it comes.  I will continue to update as my progress improves.

[kittent1211]

Glad to hear you are doing well in your recovery.  Before I had my surgery I couldn't even walk well, my knee would buckle and I was constantly falling and it hurt like hell when it did that.  So, I consider the fact that I can walk as a victory.  I just enjoy the activities I can do and I don't worry about what I can't do any more.  I used to like hiking but I had to give that up and that was a tough thing for me to accept.  But, I have a good time riding my bike and swimming. 

[XT]

Marathoner...

I don't know if my story will give you any encouragement, but here it goes...

I had MFX on my right lateral articular cartilage 3 years ago this December.  I had a rough 8 months post surgery.  After 6 weeks NWB I thought I would just walk out of the OS office...but it took another two weeks before I could even walk.  I spent the next six months second guessing if I did the right thing by having the surgery, and then I turned the corner.  I was finally released to do non-impact activities and the first thing I tried was a spin class.  Wow...I hadn't done anything to break a sweat for well over a year and it felt great!  After a few months of spinning I bought a road bike and started riding with a triathlon group.  Of course I couldn't run and swimming more than a few laps was laughable...but the idea of doing a tri became very appealing.  Could I come back from this and do something I have never thought of doing before?  When I was finally released for impact, my OS said I could run a little, but just not to go training for any marathons.  So I did...I started training for a sprint tri.  I figured if I could get the swim part down I could do it whether I could run the whole thing or not.  I did my first sprint tri in May of last year and have completed 6 since along with the bike leg of an Olympic tri.

This is actually my first post...I got on here this week to see how others were doing with running after MFX.  I never thought I would run again...I don't even know that it is the wisest thing to do, but right now my knee is holding up and I choose to do it because someday I won't be able to.  That day is not today!  I ran 7 miles this morning in preparation for the PF Chang half marathon in January.  I have the voice in my head (my OS) telling me just not to train for any marathons, but I just can't help it.  I have had some set backs, but I am learning when I have overdone it and need to take a break.  I have recently started taking glucosamine/chondroitin as I keep reading how I should take it.  My goal next year is to do an Olympic Triathlon and then my hope is that I will be over my need to prove I can come back and just be happy with sprints.

Take it step by step...it's a long recovery, but it doesn't mean you are doomed!

[rwwerd]

3 weeks + 1 day....

XT: Thank you for your words of encouragement.  They are definitely needed and I am glad to hear that you are doing well after the MFX surgery.

So it has been 3 weeks and a day since my surgery and I am starting to feel pretty good.  I have all of my ROM back and still have some swelling around the surgical site.  I am icing it throughout the day and keeping it elevated to try and alleviate the swelling.  I have been doing my leg lifts, quad sets and using E-stim to strengthen my leg.  I have started adding ankle weights to those exercises and doing some minor hip work.  I had a set back a week ago....I was getting around on my crutches and I one of my cruthces caught the bottom of the curtain and I slipped and fell.  I had to go have x-rays done and luckily it was just a Grade 2 ankle sprain and nothing worse.  I am now in an Aircast an go back in 2 weeks to get the ankle/foot re-evaulated. 

I am going back to the OS in 3 weeks to find out if I am able to start weight bearing.  This would be at the 6 week point!  I am anxious to get back into PT and start trying to walk and re-gain that part of my life back.  I assume after a few weeks of training my brain/leg to work again I will work more on strengthening.  Overall things have gone smooth up to this point.  I will keep everyone posted on how the next three weeks go!

[rwwerd]

4 weeks + 1 day....

Today I went back to the OS for my 4 week checkup.  My knee looks great and I finally have full ROM.  It still is a little swolen and tight in the my quad.  My OS told me that in two more weeks that I will be able to start walking.  He told me to gradually increase my weight on the foot by 10% everyday.  I will be going back to physical therapy to have help in retraining my mind to walk again and help with my strength.  I am glad to finally be done with the crutches.  I will keep everyone updated on how the physical therapy and walking goes. 

[Martin-R]

Thanks for posting RW.

I'm on day day 10 post op from a MFX so about 3 weeks behind you. My recovery was going swimmingly but I made a cockup getting out of the bath on day 7 and the swelling has come back with a vengeance. Unfortunately I'm on Warfarin which is not a good bed-fellow for MFX and my surgeon thinks I've got a bleed in the knee. Waiting until Wednesday to see if it'll sort itself out or needs to be aspirated. Annoying because prior to that I was completely pain-free and ROM was up to 90 degrees. Now got a bit of pain and ROM is down to 45 degrees 

Fingers crossed for Wednesday!!!

[Amy29]

Hi rwwerd;

I am almost 4 weeks post op from MFX, my flexion is at 90 degrees but I am lacking 30 degrees extension.  My Physio says this is because I am guarding and my muscles aren't relaxing.  Any ideas on how I can get my muscles to relax?

[rob43]

ive also had a microfracture i am 7months post op, far from back to normal, but working really hard day by day
i,m jogging 3times a week and weight training 3times a day to try and build muscle on my chicken leg!
i,m not pain free yet and knee is still weak!

[Maverick]

I am a 48 year old very active female, former MMA black belt, rock climber, cyclist, etc.  I am accustomed to working out 8-10 hours a week.  Last September I had a Lateral femoral condyle (LFC) microfracture (grade 4) in my left knee along with a lateral meniscectomy.  Surgery included 7-8 microfractures.  I am in my 8th month of recovery and it is going very slow.  I spent 2.5 months non-weight bearing and did not get off crutched completely until 5 months.  Waiting this long ended up with significant atrophy in my leg.   I have an unloading brace that I just recently set to no-loading (0 setting) but still wear when my knee starts getting painful.  I am diligent about my strengthening and I work out at the gym 3-4 days a week with 30 minutes cycling (90 cadence) and using weight machines for leg press, leg extension, leg curls and abductor exercises using a cable and ankle cuff. I still have significant knee pain in the microfracture area most of the time and worse at night.  My surgeon did a bone scan and MRI at 5 months to determine if there were any issues with the knee.  Nothing showed up other than thinning cartilage in the original injury area.  Although my recovery is slower than I would like, I am better than I was pre-surgery.

I am told that I can no longer run and the pain is what is really getting me down.  I scheduled an appointment with my OS for 6/20 to discuss options.

I know that fibro cartilage is thinner and rougher than normal cartilage so can this contribute or be the issue for my continued pain?  Any thoughts or similar experiences?

Any feedback is appreciated.