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Author Topic: Microfracture recovery  (Read 405 times)

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Offline Celina1989

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Microfracture recovery
« on: April 07, 2018, 09:04:11 AM »
Hello fellow knee sufferers. I would like some information and share some experiences on microfracture surgery. I have read a couple on this forum but they are older so I'm starting a new one.

Im a 28 yo woman. I had 4 months of knee pain in advance to my surgery. I wasn't able to do my nursing job and couldn't walk painfree for 10 min, of course stairs were a struggle and more. First time at OS I had a cortisone injection what temporarly worked. At the beginning of march I had an MRI which was inconclusive. They found a tiny loose body and a surface That was somewhat different on the medial femurcondyle. About 8 y ago I had an MRI which was very much the same. Back then I had a loose body removal, the OS didn't know where it came from. My OS gave me a tiny warning on "making holes in the bone" when we decided for explorative arthroscopy. During the surgery on March the 29th he found a grade 4 cartillage lesion sized 2 cm by 2 cm on the lateral side of the medial femurcondyle and microfractured it. After surgery I didnt get much more advice then PWB 50% on crutches.

The next week I called the hospital since I really wanted to know more. My OS called me back and said Im allowed to do NWB active exercises. I need to be on crutches for 4 to 6 weeks. Also he said I could go back to work after FWB but preventing intens movements for the next couple of months (squating, lifting, running). Yesterday I tried 10 min of active exercises after 1,5 h of CPM. I hired the CPM after so many positive experiences on here and also some research I did, since it is not standard practise in my hospital (Netherlands). But during the third round of active exercises I felt a sharp stinging pain so by then I quit and only did CPM. I just tried to stay of the oxycodon but took one in the evening. This morning it was still painfull, a bit less but I have decided to take it easy. I saw some advice starting to do active exercises after week 2 so I think I will hold on to that.

I am wondering how your first weeks went / are going and what you were allowed to do?



Offline Dave33

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Re: Microfracture recovery
« Reply #1 on: April 07, 2018, 03:12:03 PM »
That's a fairly big lesion for microfracture, unless I'm mistaken; I'm not sure what you're able to get in the netherlands, my understanding is that microfracture is not ideal nor durable compared to an OATS or ACI procedure - however it is a lot cheaper and easier for the health system/surgeon.

When you say active exercises, I think probably the best bet is to move the knee, but not to load it - you want movement for the synovial fluid to nourish the joint and protect scar tissue, but you also don't want to load the lesion that now has a fairly unstable blood clot filling the defect from the microfracture. Very light cycling might be a good place to start, but obviously check with your PT. I wouldn't be doing anything other than minimal walking with the crutches for the first 6-8 weeks.

My microfracture failed, but it was on the patella, and nothing really works there... you could have better luck, but if it was me, I'd go really easy on it for 3-4 months from a weightbearing perspective. My personal opinion is that for the recovery phase of a cartilage procedure, rest is far more important than physiotherapy.
« Last Edit: April 07, 2018, 03:20:59 PM by Dave33 »

Offline Celina1989

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Re: Microfracture recovery
« Reply #2 on: April 07, 2018, 06:00:24 PM »
Hi Dave, I am very sorry to hear that your microfracture failed. All the mental waiting game and effort. I would be very sad. What did you have after your microfracture surgery as treatment?

Because it was an unexpected finding I didn't research on it in advance. I now read that microfracture can be used till up to 4 square cm, so I am thinking mine is average. Im also low in most other risc factors except for the wear and tear and possibly then size of the injury.

My microfracture location is NWB so I thought I should be able to do exercises without increase in pain but I got proved wrong. Atm I am increasing my ROM by 5 degree a day but it is only 60 atm. I can do 90 for like once with some discomfort but I don't want to push it too much. As soon as my range of motion is good enough for cycling I will start with it. Cycling was the one exercise that never hurted. I got a bike in my living so thats convenient.

I am a bit confused about my OS saying I can go back to my job after 6 weeks but avoiding lifting, running and squating and maybe other intense knee movements. I wonder how I can do my job then.. But I should try not to be concerned by this now so early after surgery xD


Offline Dave33

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Re: Microfracture recovery
« Reply #3 on: April 07, 2018, 08:02:48 PM »
Hey thanks Celina -  no worries though, one door closes, another opens somewhere. I'll likely get a partial replacement later this year.

For my microfracture,  I basically was told I could bear weight, but only in extension - which makes sense, as my lesion was on the patella. If yours is on the femural condyle, I'd think weight bearing would be a really bad idea. I'd really try to baby it for a good 6+ weeks, even if it feels good. Biking would be good for ROM and preventing scar tissue buildup, if that's the recommendation.

What I do remember from all my various surgeries etc is that recovery isn't a linear process at all, so don't be too worried about percived setbacks, etc, or pains that come and go early on.

cheers

Offline Celina1989

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Re: Microfracture recovery
« Reply #4 on: April 07, 2018, 09:27:03 PM »
True Dave. There is never just one solution. I hope your PKR will go well. Good luck in advance.

Well my lesion is on the lateral side of the medial femur condyle. That is in or near the fossa condylaris / condylaris notch. I can't find any specific recovery plan and advise on it. So the plan I think is closest and therefor follow is femur condyle NWB part. But I am wondering how that could get this painful in the first place, a weigh bearing spot would make much more sense. Maybe a tendon is touching the spot?

I have. Already noticed some curves. Yesterday I started some active exercises, went well at first but in the evening it started stinging painfully. So thought I have overdone it. Took a painkiller and rest. So today only CPM. But I am not doing the last 1,5 h. After dinner my knee started playing up again. Ice and a painkiller hopefully does the tric!

I know about every OS got a different recovery plan but I didnt't really get one (yet). Therefor I am feeling very insecure.

Offline Celina1989

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Re: Microfracture recovery
« Reply #5 on: April 17, 2018, 06:57:53 AM »
Yesterday after 2,5 week I had my first (and only) post op visit. My OS was very satisfied with my progress. My knee looks very good, minimal swelling. I have to take it easy for another 2 to 4 weeks. I got the pictures of my knee so if people say o just 2 tiny holes I can show m the inside xD

I did get a little surprise tho. It was not "just" cartilage but also a layer of bone. So that is called osteochondritis dissecans. It doesn't change treatment tho. I am just a bit worried it will happen again or even in my good knee since I read that's not uncommon. And can't think of any trauma that caused it.

In addition at noon I had my first PT appointment. We all were very surprised but my ROM already completely returned: -3 till 132!!! Yes thats so awesome :) even they were surprised and didn't expect it this good. He also said that my OS was known to be very careful so I am feeling more sure about the 50% weight bearing and from today on I am allowed to go on the hometrainer. For now I do PT twice a week.

I was on the CPM on 105 degree but PT said I didn't need it since I am past maximum range of motion. So yesterday evening I maxed it without an issue. I think my improvement so far really has a lot to do with the CPM. I still notice that after a long time not using it I get a very warm to hot knee. After CPM that's gone. Can anyone recall?

Tomorrow I am going to work for the first time. Taxi is picking me up. Wonder how it goes on crutches. Am not used to use m for longer then just in the house. So a good challenge. Looking forward to continue a bit more notmal life.

It is going well. Happy to be able to actively improve my recovery now. But starting slowly.

Offline Celina1989

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Re: Microfracture recovery
« Reply #6 on: April 26, 2018, 10:58:42 AM »
After the first PT training on thursday it went a bit downwards. A lot worse feeling in my knee (like a week before: burn and pain). I was a bit anxious about my next PT appointment which was 2 days ago but that went much better. Just a normal work out feeling. So the day after I was free from work and enthousiasticly started all my exercises, maybe overdid it a little cause when having dinner while half laying on the couch i felt a strong painful sting in my knee. Relaxed the rest of the evening and iced my knee. Normally I get this during exercise so I was surprised. Exact 4 weeks after surgery now btw! The worst has been :)

I still have a couple of short and longterm questions.

Short term:
- I still very often get a sleepy / tingling feeling in my knee / lower leg if I don't put it up. I already had this before surgery. I am wondering how long it took you to get rid of this?
- also I can't put my blanket over the inside of the knee. The outside can handle much more but I guess since the microfracture side is more on the inside. Do your recognise this and when will it dissapear? Or any temporarly solutions?
- Do you have any trics to figure out when you have 50% weight bearing? My PT did practise it on a scale but that is different then while really walking.
- When will I be able to walk stairs since my bedroom is in the loft and I still sleep in the livingroom now?

Long term:
- Now I have read some more about long term microfracture results it is kinda like 2 good years (about 80% succesrate) and then it will detoriate, of course some people last way longer. Im wondering about your personal experience?
- very specific: is somebody a nurse / healthcare worker and returned back to the job after surgery? How long after surgery? How does it go now? Reinjury (wear and tear) or full functioning?

I check this forum multiple times a day but since then there were no new microfracture experiences.

Thanks for reading, stories and advice. Would like some help with the next phase of recovery :)















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