KNEE ARTHRITIS - Bone marrow stimulation :

Microfracture rehab - - Posted by Riosilia (Riosilia), 4 May 2003

I was hoping someone could tell me what their rehab was like after they had microfracture.  And if you don't, please tell me where you had the microfracture.  

I'm having mine in my patella (in the distal, medial portion; type III defect).  I'm having some other stuff done at the same time (maquet, patellofemoral ligament repair, and lateral retinaculum repair) so I think my rehab will be a little diffferent.  So far I've been told that I would be weight bearing as tolerated (hinged brace and crutches) for the first six weeks and  using a CPM machine.  THe first 3 weeks I would be looked at 0 degress and than the next 3 I would start working on ROM.  

Also, I'm a high senior, going to college in the fall and move in day is the 3rd week in Aug.  Right now my surgery is scheaduled for June 26th (that will give me almost 2 months).  Is that enough time?  Will I be ok walking around campus in those first few weeks?  I'm trying to move my surgery up but it's hard because of graduation and my doctor is going to be on vacation.  SHould I be worried about this whole college thing?  

Any comments or advice is greatly appreciated!

   ~Riosilia
Posted by JG (JG), 5 May 2003

Riosilia,

Try the following website:  http://www.steadman-hawkins.com/knee_microfracture/overview.asp  

It explains the procedure and rehab.

Janice
Posted by JG (JG), 5 May 2003

Roisilia,

I noticed your response in the surgical forum.  You would be okay to bear weight because the patella is a non-weight bearing bone (unlike the chondyle or tibia).  You would be locked in a certain position in the brace.  The Steadman-Hawkins overview talked mostly about the chondyle microfracture which would require a being non-weight bearing for 6 - 8 weeks.

Janice
Posted by Riosilia (Riosilia), 6 May 2003

Thanks Janice!  This makes a lot more sence now!  ANd the web site was very helpful.

    ~Riosilia
Posted by katie (katie), 6 May 2003

I had the microfracture in HOSPITAL of course... baaa-dum!!

<silence>

I had a chondral lesion removed and microfracture on my medial femoral condyle in Feb 02. Prior to this I was non-weightbearing for something like 4 months while I misdiagnosed a few times and then we "waited to see if it would get better without surgery".

This was on a Wednesday afternoon. Discharged Thursday, removed most of the dressings on the Friday. I was sore, but back at work on the Monday.

Tuesday I went for a check up, and my surgeon took one of my crutches off me[1] and said to start putting weight on my leg.

[1] Figuratively. Actually it's still in the garage.

The stitches were taken out on the Thursday. This was slightly more complex than necessary because my skin heals fast... and the stitches were at this point /under/ the healed skin.

Suggestion: if your skin heals fast, book this appointment a bit ahead of suggested time and miss the "having your incisions re-cut open" experience out.

And I was told to stop pissing about and walk properly, it couldn't possibly hurt that much.[2]

[2] Obviously, this came with different words, but that was the intent.


Now, this is the bit that worries me a little: everyone else seems to spent 6 weeks non-weightbearing. My surgeon also says he's done lots of these, but I have to say the physio department don't seem to end up seeing them because when they read my records they go "Hmm." and wander off to get more opinions on what they do with someone who's had microfracturing.

{I'd think with the other messing about they'll not be keen on you using the knee a lot - ligament repairs, I'm led to believe, require a while to settle down.}

There wasn't any CPM machine featuring in my life either, which seems to be fairly strongly featured in all the web articles.


Physio consisted of: several hydrotherapy sessions (actually these were quite fun up to the point where I tore my calf muscle), cycling etc and some balancing exercises that we eventually gave up trying to get me to do, on the basis that I couldn't balance like that BEFORE surgery...

So, I was in physio for Some Time, until they finally said "hurrah, you're fixed" and discharged me in November. I spent Jan and Feb feeling fine and have since rebounded with "generic hurty knee" and I'm back there a week today to see if things have "improved". {This is "improved" in the sense of "physio says so", rather than any actual "hurts less". It's not that it actually hurts /THAT/ much. It's only wincing pain, not screaming pain, it's just that it DOESN'T STOP that makes it annoying.}


I don't know whether the CPM/non-weightbearing thing is a cultural difference between UK and US treatment or what, but I'm a bit concerned about all this...

Posted by dhalem (dhalem), 13 November 2003

I am 31 now, but also had Microfracture at end of my senior year of high school.  I was a football player, and was playing in college, so I had about 2 1/2 months to be ready for summer camp Aug 15.  

From what I remember,  I did not have a CPM, which were not used too much back in 1990.  The CPM will help you greatly.  I was partial weightbearing for 4-6 weeks.  After this I began more aggressive rehab and was running again by mid to late July.   The microfracture worked for about 10 years, but all the pounding from sports led me to more operations recently.  I just had bone graft done, and lateral releasae.  I have a problem with scar tissue.  If you do not develop scar tissue problems, there a few procedures available to you to fix chondral defects.

By the way, my defect is partial trochlear groove, lateral femoral condyle and about 1.5 Cm.  

good luck !

Dan

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