KNEEtalk

The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: nursedeb on May 29, 2010, 05:33:36 PM

Title: Frustrated after microfracture surgery
Post by: nursedeb on May 29, 2010, 05:33:36 PM
Hi everyone,
I had microfracture on 4/19/10 for a 1.5x1.2 osteochondral defect in the medial femoral condyle. On May 25th, which was exactly 5 weeks and 1 day after surgery I went to the ortho. I had full range of motion, very little pain and minimal swelling. Because I was doing so well the doc said I could try to walk. He placed me in a brace in locked position and told me to walk like a pirate, "peg-legged". The first few steps were painful but I figured that was normal. I tried walking down the hall, and every step I took I had a sharp pain about 5/10 in the exact spot where he did the surgery. He said ok let's back off and go two more weeks of non-weight bearing. I just wanted to pull my hair out. I wanted so desperately to walk, but I also didn't want to push things. Has anyone else experienced a similar situation. How long does it normally talk before you can walk without pain. I understand that some pain is normal, but I can't possibly imagine having a sharp pain with every step. He said that some patients are non-weight bearing for up to 12 weeks! Yikes! I think I'll be in the nut house by then, and so will my husband  :P Any words of advice or encouragement from fellow micro-fracturers would be greatly appreciated.
Thanks a million
Debbie
Title: Re: Frustrated after microfracture surgery
Post by: jt801 on May 29, 2010, 07:16:07 PM
Hi Deb-hang in there! I didnt walk until midway through my 7th week of NWB, so you are doing ok. My advice is to wait a little while, then try to start walking with your crutches still supporting most of your weight. That way you can gradually increase the load on your bad leg. I started that process at about the 6.5 week mark and after a week or so of doing that i finally was able to ditch the crutches and could walk naturally without pain. I know its frustrating but if you can take things slowly and not push yourself too much, you will be much better off in the long run. Good luck!
Title: Re: Frustrated after microfracture surgery
Post by: nursedeb on May 29, 2010, 08:14:08 PM
Wow so it's been almost a year and a half since your surgery are you still walking pain free
Title: Re: Frustrated after microfracture surgery
Post by: jt801 on May 30, 2010, 02:56:11 AM
Yes-i still have some soreness from time to time, but i have been playing sports and doing whatever i want for the past 5 months. Its a long road back but you will get there.
Title: Re: Frustrated after microfracture surgery
Post by: Saints21 on May 30, 2010, 07:49:46 AM
Hi deb.. we had the same surgery 10 days apart so we are almost the same.... The thing that strikes me is that you have been NBW for the whole 5 weeks... I mean even in PT???? If thats the case I guess all your muscles are very weak...(ive been liftinh weights in PT since 4 days after the surgery and I still laugh when I see my leg it looks so wierd withoyt the muscles)  that may be the cause of the pain .. right now you are only using your knee, cause you have no muscle to support the leg....

Ive been walking with crutches for 3 days, pain free.. rode the bicycle today with no pain... swimming with out a pull bouy for 20 minutes and even doing "like" squat exercises with no pain ... although the difference between us may be that im lifting 7 pounds on my leg already, and I have more muscle now than when I went the first time to my doctor... I am no doctor, but if you are doing PT without weights that may be the cause of your pain

I hope you get better soon, This is my second operation and in my experience you have to maintain a positive attitude... believe it or not you body will react different if you are positive instead of negative!  that will make it a lot easier!!!!

JT im really happy that you could go back to your normal life.. im ready to sacrifice basketball and jogging if that gives me 3+ years of flag football.. its too early yet but thats my goal!
 
Title: Re: Frustrated after microfracture surgery
Post by: nursedeb on May 30, 2010, 06:30:01 PM
Hi,
I find it interesting that you were allowed to use weights with PT. My doc said absolutely no weights until my weight bearing restrictions are lifted. So, were you non weight bearing for 6 weeks? Also, you mentioned this is your second surgery. Is this your second microfracture surgery? I hope not. I certainly don't plan on having than done more than once. If the microfracture doesn't work, I'm going to try the OATS procedure. Besides, I've read that OATS has a better long term success rate than microfracture. My doc doesn't believe in the ACI?
Debbie
Title: Re: Frustrated after microfracture surgery
Post by: Saints21 on May 30, 2010, 08:02:10 PM
Hello!

I was prohibited from putting any weight in my leg (like walking) but in PT I have been using weights I think from the second week... no discomfort.. no pain ...

Gradually ive been increasing the weight bearing, and I am right now on 7 pounds.. with no pain .. which has helped my because I have muscle to help the leg

The thing I dont understand about not doing weights in PT is that your leg must be very very week, hence thats why I THINK you are having so much trouble walking

That said, its important to mention that I never had any problem walking before my surgery .. I had no pain at all.. my problem was that I had a swelling that did not go away, and since I could not lift weights for my leg, it was impossible to get muscle... I could run spin cut, do all these things without pain .. the problem was the swelling afterwards...(when I got the MRI I had even tendonitis on the MCL, probably because of my forcing my injured leg!)

This is my second surgery, I had surgery 10 years ago to repair a meniscus in the same leg.. whats interesting is that I thought that, since I had part of my meniscus missing, I though the injury to the cartilage was right at the point where it was missing, but my surgeon told it was in another place.. so Its possible that I banged it some time ago and it just finally decided to give out

So, in these 2 more weeks you cant add weights in PT.. I mean every doctor has his protocol, so I dont know.. what I do know is that if I was lifting weights in PT (I mean the simple exercises like raising your leg straight up, sideways etc) and I had even the minimal, pain, I would stop but I had no pain at all....

I hope you get better, I still dont know if it really worked until two more weeks (8 weeks the crutches are going away) but as of right now, I think it is going well!

I hope you get better!!
Title: Re: Frustrated after microfracture surgery
Post by: nursedeb on May 31, 2010, 01:43:20 AM
Hi again,
I actually went on the web site for Dr Steadman, he is the guy who invented microfracture. According to his rehab protocol, there should be no weight bearing at all for 6 to 8 weeks, this includes PT. Hopefully, with the quad sets and straight leg raises that I have been doing, I will have some strength. I do feel like my quad muscle has gotten a little bigger in the past month. So you said you ditch the crutches in two weeks. I assume you have been "walking" with the crutches as an aid? I'm sure once I start walking I will need to do the same thing. My doc said that once I start weight bearing, I have to wear a brace and walk with a straight leg for one month. I'm not really sure why, except that I guess it takes some of the load off the knee because you don't bend the knee. Then once I start walking normally, I have to wear an unloader brace for up to 6 months. I guess my doc wants to make extra sure that the surgery works. I find it fascinating that there are so many different recovery protocols for the same surgery. I have read on this blog where some patients are actually weight bearing on day one. That just doesn't sound right to me. I have no problem waiting 7, 8, 9, 10, 11 or even up to 12 weeks before I can walk. I just don't want to have severe pain when I finally do. When I tried to walk in the doc office last week at five weeks post op, the pain in my knee was pretty bad. There's just no way that I could function like that on a daily basis. When you first started walking did you have pain? If so, did it get better the more you walked. To tell the truth, I'm scared. I'm also kind of angry, because I went in for a meniscus tear and came out with this surgery. The doc keeps saying that it was "medically necessary", but I would have liked to have been given the choice. Oh well, what's done is done. I just hope and pray that in the end it all works out. I really just want to get back to my normal life. I also wish you the best as well.
Debbie
Title: Re: Frustrated after microfracture surgery
Post by: Saints21 on May 31, 2010, 03:53:21 PM
Hello Deb!!!

I know its frustrating to go through with this! (imagine me, I am a pretty active guy, play sports year round so I cannot botch up this surgery)

Keep in mind that it is also important to know where the defect is.. im guessing ( i guess a lot) that since I had no pain whatsoever when walking that it was not in a weight bearing area... so maybe thats why my PT protocol is different

I have had no pain whatsoever when I walk with crutches (although I am a little hesitant to put too much weight, but when I do, I feel no pain), no pain in the bike, and no pain swimming...basically for me its gonna be wait and see if I can return to sports and in what degree

I kind of take it that your defect was in a weight bearing area??

The thing with microfracture, I think in the past doctors would see the injuries when operating but would not "fix" it because it could not regenerate.. I guess now that there are different techniques, they are trying to do whats best for you .. no one wants a knee replacement in the future

I love my OS, he is a very good doctor, he has operated even on MLB pitchers...important ones (i am not from the states).. so I trust him with his judgement :)

I hope you get better, as I commented before, dont get angry and depressed.. I believe that the body responds differently (including healing) depending on our moods.. its kind of sappy but I believe that :)

Good luck!!
Title: Re: Frustrated after microfracture surgery
Post by: nursedeb on May 31, 2010, 06:26:41 PM
I know you are right I should have a better attitude believe me I am trying I guess I am  just frustrated I hate depending on other people to do things for me Im used to being very independent and yes you are right mine was in the medial femoral condyle (weight bearing) area I guess that's why my rehab has been different than yours that would also explain why I have way pain with walking it's just hard for me to understand why I have way more pain now (when walking) than I ever did before the surgery mostly before I just had soreness and aching after exercise or long walks I never had sharp pain I'm returning to my job tomorrow and i'm nervous I work as a nurse case manager in a large city hospital and my job involves a lot of walking you will probably laugh but I have rented a scooter for the first two weeks but once my weight bearing restrictions are lifted I will have to start walking again and those hallways are long for the first week or so I figure I will be pretty slow and I may have to slowly wean off my crutches I also have to wear a brace whenever I'm walking which keeps my knee in a straight position I may have to use a few weeks of FMLA during that time thanks for words of encouragement I suppose a prayer wouldn't hurt either just curious if you are not from the states where are you from? It's memorial day here I'm down in Florida and Its hot hot hot!!! 
Title: Re: Frustrated after microfracture surgery
Post by: Saints21 on May 31, 2010, 08:51:16 PM
Hi!

Hot!! you say Hot!!!!!!!!!! haha

I live in Panama City Panama!! try hot and humid!!! its horrible here!!!!

The combination between depression and anger and fear (yes fear, fear that everytime you take a step its gonna hurt horribly) is a bad one.. thats why a good attitude is needed!

Well maybe it hurts more now because the doctors have to "cut the cartilage" that does not work and maybe thats why ...?

I remember 10 years ago my first surgery I could not stand the pain .. and it was a simple meniscus removal (partially torn)

But over time, it got better.. and better and better.. and before you know it, I went on and played all the sports and did everything I wanted for 10 years!!!

I know this is more complicated than meniscus but hang in there!!! it will get better!!!!!!!!!!!!!!!! :D
Title: Re: Frustrated after microfracture surgery
Post by: nursedeb on May 31, 2010, 10:10:20 PM
Cool panama city hablas espanol? I can see why you play sports year round the weather is nice there well hot and humid nice I've always wanted to take a cruise down the panam canal oh well maybe I can when my knee gets better you are right i am really going to try hard and have a more positive attitude I don't think I mentioned this before but I had a few mishaps with the crutches where I slipped and to stop myself from falling I had to step on my bad leg my doc said not to worry about it but I can't help wondering if this somehow messed up my surgery did this ever happen to you?
Debbie
Title: Re: Frustrated after microfracture surgery
Post by: jt801 on June 01, 2010, 12:16:30 AM
Hey guys-let me tell you something interesting: I was never prescribed any kind of PT after my surgery. I started riding the stationary bike at about the 2 week post-op mark (my idea-my OS said it was ok) and continued for quite a while after i got of crutches. I firmly believe that the extra time i spent on crutches and just completely taking it easy for the first 6 months contributed to my being where i am today. And yes, i did slip and weight my leg several times while on crutches so i dont think its anything to worry about.
Title: Re: Frustrated after microfracture surgery
Post by: nursedeb on June 01, 2010, 01:31:58 AM
So how long were you on crutches? And did you have to wean off them slowly? Today is six weeks on crutches, and I have them for at least one more week. Did you have pain when you first started walking?
Thanks,
Debbie
Title: Re: Frustrated after microfracture surgery
Post by: jt801 on June 01, 2010, 04:31:51 AM
Hi-i was on crutches for 7 1/2 weeks. Yes, i did slowly wean myself off of them. By that i mean that i started letting my foot touch lightly while taking normal steps, yet the crutches were still supporting my weight. I started around the end of the 6th week. Sorry if that sounds confusing-if you try it you will see exactly what i'm talking about. The biggest obstacle was psychological-i had become completely dependent on the crutches to get around and i was so used to them that i didnt feel any real urge to try to get along without them. Does that make sense? Finally i just took a leap of faith and walked across my shop (about 30 feet) just to test things out. I thought well, if this is awkward or painful i'll just keep using the crutches. Thankfully, i had no pain and my gait was pretty normal. With all that said, i'm not trying to proclaim myself as any kind of expert. I'm just happy to share with you what my approach was and what worked for me. Good Luck!
Title: Re: Frustrated after microfracture surgery
Post by: nursedeb on June 01, 2010, 02:24:48 PM
Wow, that's awesome that you walked across the floor 30feet. I know what you mean about the psychological fear. I am scared to death. Last week in the OS office I tried to walk a few feet and every step I took I had sharp pain where he did the surgery. So he said to wait two more weeks of nwb. I know that some pain is normal, but I don't think sharp pain is normal. Did you every have sharp pain while walking. I just get so frustrated because that sharp pain that I felt I never felt before the surgery. All I had was aching and soreness. That's what gets me so mad. I went in for a meniscal tear and ended up with this. But from what I've read I'm not the first person to have this happen to them. Also, your defect is lateral and mine is medial (weight bearing). I think that's why I had more pain with walking than you did. I feel like this is a nightmare that will never end. I just want to get back to my life.
Debbie
Title: Re: Frustrated after microfracture surgery
Post by: Lottiefox on June 01, 2010, 02:56:40 PM
Hi,

Lateral defects can also be weightbearing, it is the spot on the condyle that creates the issue, regardless of lateral or medial location. I have a 1.5cm squared medial lesion (grade 4) on the medial condyle. It aches at times and if I hit the wrong angle it hurts. I think after MFX sharp pain can happen - after all the surgeon has drilled holes in your bone and that is going to hurt with weight on it. I was recommended MFX for my lesion but decided against it (I am 41, want to be able to do impact work etc etc, plus my patella defects cause me more trouble..) and my OS said that people often have pain way after the period of non weight bearing...but gradually it goes......

You are not alone unfortunately in your surprise MFX experience. I know surgeons feel they are helping but it can be doubly frustrating to go in expecting a tear, and come out with MFX especially if you weren't have symptoms much before from the defect.

hang in there, MFX can be a long recovery. Remember that the muscles will also have weakened and that doesn't help with creating any form of natural brace for the knee to work in, hence more pain loading onto the spot thats sore.

Hope things get better soon

Lottie  :)
Title: Re: Frustrated after microfracture surgery
Post by: Saints21 on June 01, 2010, 03:09:48 PM
Hola Deb

Claro que hablo espaņol, soy 100 por ciento panameņo!!!

Call me crazy but I would prefer to live in a cold climate!!! I like it more!!!!!!!!!!!

Plus ive always wanted to play football in snow.. seems so much fun

The comment made some posts ago makes sense, basically the surgeon has "broken" your leg in order to fix it.. although a very small hole.

And even though my MRI showed a meniscal leasion.. the doc said that both meniscus are fine (even the one that he operated on 10 years ago, which was a welcomed suprise).  So even the best doctors can get wrong diagnosis from mris

I also am 100 % sure most of the trouble is psicological the lesion will heal to some extent but you have to "let go" mentally...

Well deb, I had one misshap, I accidentally stepped on my crocs with my crutch and went to fell down, and put the leg down almost with full force but it didint hurt at all.. so that it a mental hurdle passed

I have a friend that also did this surgery, he does whatever he wants right now but he told me that its a long process... first you have to deal with the crutches then regain balance then regain strenght.. is complicated!

even though when I write that I am doing 7 pounds on pt may sound a lot that very little for what I want to do.. I need to do at least 150+ pounds (using both legs) to get my legs as strong as they used to be, and that takes time.

I just want to get out of the crutches and start going to the gym (I started going yesterday, it was complicated but it felt so goooood haha) and just get back into my daily routine... when I hit 4 months post op i'll see where i am at!!!!

impossible is nothing!!!!
Title: Re: Frustrated after microfracture surgery
Post by: Saints21 on June 08, 2010, 04:09:19 PM
Hi Deb!

Just wondering how you are doing!!!

Later!
Title: Re: Frustrated after microfracture surgery
Post by: nursedeb on June 08, 2010, 09:45:41 PM
Hey I'm actually going to the doc today and hopefully I can start walking I have to wean off the crutches for two weeks I use both crutches for one week one crutch then I'm on my own wish me luck how are things with you?
Title: Re: Frustrated after microfracture surgery
Post by: Saints21 on June 09, 2010, 02:49:49 PM
I am glad to hear that!

I am also going to the doctor today to eliminate both crutches!!! Hope everything goes well kind of nervous!

I took the rest of the week of so I can Ice the knee like every 10 seconds!!!! we'll see what happens!!

Good luck!!!
Title: Re: Frustrated after microfracture surgery
Post by: jt801 on June 09, 2010, 05:51:50 PM
Best of luck to both of you!
Title: Re: Frustrated after microfracture surgery
Post by: Saints21 on June 10, 2010, 04:43:39 AM
Well, crutches are off!!!!!!!!!

I can walk "funny" but not a limp... no pain at all.. just a little discomfort, but I guess that because of not walking in two months...

I am very happy because the "snapping" I had everytime when I would start walking SEEMS like its gone away ... i tried to walk up and down the stairs... no pain !!!

This is very positive, but I wanna wait tomorrow to see if it swells... but im really happy for the results right now...

now comes the hard part.. really rehabilitating the injury...!!!!

Title: Re: Frustrated after microfracture surgery
Post by: nursedeb on June 13, 2010, 02:18:01 AM
Hey Everyone,
Hope you are doing ok? I went to the ortho this past Tues. I assumed that he would let me try to walk again with the straight leg brace. He walks into the room and says "how are you feeling?". I said pretty good, my range is motion is excellent, my swelling and stiffness are minimal and I have no pain. Then he simply said that he wanted to wait until I get the custom fit unloader brace before I can walk. He said it would  take about 7 to 10 days. I was very frustrated because I couldn't understand why he wouldn't just let me walk with the straight brace until the unloader brace comes in. It just doesn't make any sense to me. The only thing I can think of is that he is just being really cautious with me, and he probably figures that the unloader brace will be less stressful on my joint than the straight brace. Just two weeks prior to this visit I had tried to walk with the straight brace and I had quite a bit of pain. So, my the time I get the unloader brace, I will have been non weight bearing for about 8 and 1/2 weeks. That seems like a really long time to me. However, if you read Dr Steadmans protocol for microfracture, he recommends 8 weeks of non weight bearing. So, I guess that's still within reason. I just worry about loss of muscle strength. All I have been allowed to do are straight leg raises and quad sets. I'm getting an exercise bike soon, so that will help. I gotta say that I am very nervous about walking. Considering that I had very little pain before the surgery, I really hope that I don't have a lof of pain or I will probably feel very discouraged. The rehab for this surgery seems quite extensive however. And I've read that it can take up to and year and 1/2 before you reach full recovery. I feel like I'm going crazy because Im already researching other options if the microfracture doesn't take. I think OATS is the best way to go, but who knows. Anyways, I guess it's one day at a time. Peace.
Title: Re: Frustrated after microfracture surgery
Post by: poikiloid on June 22, 2010, 07:53:32 PM
Hi Deb,
According to a few recent medical journal articles, I think it's becoming more common to use an unloader brace for a while once FWB. Do you know if you have any bow-leggedness, as it is even more recommended in that case.

Don't be surprised if you have knee pain for 6 months to a year postop. That's microfracture: slow slow slow. The knee is supposed to continue improving up to 2 years postop. The advantage is it's a more minor surgery than the OATS you mentioned. There is a lot of research going on, hopefully options that are much better than BOTH of these will be available in the next 10 years.  Keep your leg muscles, esp quad, in good strength, and your microfracture results should last a long time though. Steadman has already published patients doing fine after 17 years.

I have some questions about the unloader brace, if you wouldn't mind looking: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=51941.0
Title: Re: Frustrated after microfracture surgery
Post by: BlueTopaz_ZA on September 15, 2010, 02:54:42 PM
Nursedeb & Saints21 ... wondering how you are both doing @ this point post MFX surgery?

I am now almost 4 weeks post MFX + ACLr and meniscal trim, but its the MFX thats daunted me most!  :o
Title: Re: Frustrated after microfracture surgery
Post by: Saints21 on September 15, 2010, 05:35:40 PM
Hello!!

Well I am doing fine!! I've already played two flag football games with no problem whatsoever.. no swelling or pain afterwards  (I am not running, since I play QB I just throw the ball).  I've run, but still dont want to force the knee too much

still trying to regain muscle, long way off!!

But now I sprained my back haha!! cant catch a breaj!! I hope you are all doing all right!!!!
Title: Re: Frustrated after microfracture surgery
Post by: BlueTopaz_ZA on September 16, 2010, 07:45:14 AM
Hi Saints

Tomorrow I can start PWB with 2 crutches, this to continue for another 2 weeks.

Much like Nursedeb, no weights allowed during exercises, and only start bicycle in week 6, so its a fairly conservative protocol but not as prescriptive as some I have seen which require NWB for 8 week. I would be going nuts by then!!!  ::) As it is, this is very frustrating and a test of my patience.  :-[

I have decided there will be no running in my future, and just to protect my knee as much as I can. I definitely do not want to be staring a TKR in the face anytime soon, if ever!

I am glad to hear you are doing so well.
Title: Re: Frustrated after microfracture surgery
Post by: Saints21 on September 16, 2010, 03:08:50 PM
I  never run, I like more bicycle or eliptic machine

That being said, my basketball days are over!! just gonna play flag football because I can just sit back in the pocker and throw the ball..!!

Title: Re: Frustrated after microfracture surgery
Post by: hikerhef on September 20, 2010, 03:12:10 AM
hi there..patience patience patience is the word..let your micrfrature heal..