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Author Topic: microfracture rehab gone wrong:(  (Read 3702 times)

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Offline slash007

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microfracture rehab gone wrong:(
« on: January 16, 2006, 05:22:23 PM »
Hi.  I am new to this board so I wasn't sure where to post this, but here is my story.  First off, here is my surgical background.  I have had five knee operations which were acl recon and meniscus removal on rt. knee, then meniscus removal on left knee, then scar tissiue removal on rt. knee, then one year ago acl recon on left knee, then 6 weeks ago scar tissue removal and microfracture on left knee.  I have also had two operations on my shoulder.  One to insert a metal plate to help my collarbone heal, and another to remove it.  Anyhow, here is my problem.

I went in for what I thought was arotho surgery on my left knee to have scar tissue removed on 12/6/05.  After the surgery I didn't see my OS but according to my sister he told her that he cleaned up some scar tissue and smoothed out some cartilege.  Anyhow, I was told in my paperwork to use cruthes and to only wb for balance, but no duration was given, so given my prior experience with artho and just cleanup I stopped using crutches after about 3 days.  I still wasn't sure what he had done during the procedure so I called to find out the details and was told that I would be breifed during my first pt visit.  I was scheduled to see a pt across the hall from my OS for follow up and staple removal 6 days later, but I cancelled that and instead went to a pt that I had been going to previously and just had my OS fax over a script with instructions.

I still went to my first pt session 6 days later and had my staples removed, and couldn't wait to check out the OS instructions.  Well, on the script it said that the procedure he did was chondroplasty and his instructions were non wb for 2-3 weeks.  My PT read it but decided that the  non-WB part was a mistake since he told me that chodroplasty was simply removal or smoothing out of cartilege and it shouldn't be problem to WB.  I called my OS and told the secratery that I needed a new script since the one he sent was wrong, but I was told that he was out of town and to call back next week.  I thought getting a new script was only a formality for insurance purposes, so I never bothered calling back. 

In the mean time, I went to PT 3 times a week for 5 weeks.  During that time for the first week I took it easy and rode the bike, did leg lifts and other minor exercises.  By the third week my rom was pretty much 100% and I started doing exercises using weights and even doing a little jumping.  I did some single leg jumps on a machine and double leg jumps up to a mat.  Keep in mind that I was under the impression that I only had scar tissue and cartilege removal, so I was pushing myself to be back to basketball by 5-6 weeks post op.  On the forth week, I intensified my rehab (per my PT's instuctions) and started doing heavier weights and alot of single leg jumping.  One day after my fourth week had passed I actually spent almost 30 minutes of single leg jumping (on my bad knee) which included jump roping and jumping up to an 18" step and landing with one leg and jumping back and forth over a string with one leg.  I also did various ladder exercises.  This was on a Wed.  On Thu. I ran around a track alt. running and walking for a 1/4 mile.  On friday I went back, but I took it easy and did very little jumping. On Sat. I actually played a couple of gamesof full court basketball.  I really did't do much, but I did run up and down the court and drove it in a couple of times. 

On the following monday I finally got to see my OS for my much anticipated follow up.  I had to wait over an hour, so I actually almost gave up and left thinking that he was just going to tell me that I'm fine and to keep doing what I'm doing.  As I was about to leave, my name was called so I went in.  After looking at my knee and asking how I felt, ( I had full rom and no pain) he showed me what he did during the sugery and told me to start jumping in two weeks.  Shocked, I then told him that I had jumping like crazy the past week and even played bball.  Now it was his turn to be shocked.  He told me that that was all wrong, but based on the fact that I was able to do those things without much pain, that it was a sign that the microfracture was working and that I should be very careful for the remainder of the rehab time.  He said I really won't know for sure untill 4-6 months later.  He gave me a new script for PT that said it was o.k to strength train and to run, and then to start two leg jumping in two weeks.  He then scheduled a follow up for four weeks.

Needless to say, I was devasted by that discovery.  I talked to my PT and he felt like crap as well, but that isn't really going to help me any.  I have been through alot, but nothing tops this.  I don't really know what to think.  After researching microfracture on this site, I feel like I have 0% chance of it working considering what I put my knee through, but on the other side, I am at six weeks post op and I have full rom and very little if any pain.  This situation has really depressed me and I havn't gone to rehab the past week.  I don't know if I should just stay off of it for a while or if the damage is already done and I am just wasting my time trying to get it better. 
Any suggestions or ideas would be greatly appreciate.  Thanks in advance.

Offline stgiles16

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Re: microfracture rehab gone wrong:(
« Reply #1 on: January 16, 2006, 06:17:54 PM »
First off, I am amazed that you can do those things with no pain. I am sooo jealous LOL. AFter my first microfracture, I was only NWB for 2 weeks. That one failed. For my second one, I was NWB for 6-8 wks then partial weight bearing for 2 more weeks then a cane for 2 mnths. This one worked. BUT I was NEVER without pain. I have full ROM but I have always had pain with mine. There is nothing that you can do now, if it worked, you  are lucky, if it didnt, well, that was one very bad miscommunication between you , your OS and your PT. I hope that since you have no pain that yours worked. I personally would be upset with my OS if he did not inform you of what was done and what to expect for pt and rehab.

good luck
missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

Offline misshilde

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Re: microfracture rehab gone wrong:(
« Reply #2 on: January 16, 2006, 06:47:49 PM »
Hi, I thought pain and swelling was supposed to be yout guide..if you have neither...you should be fine...I'm going by feel and am very aggressive in my PT...I'm 4 weeks PO from LR,patella debriedment and  alot of other stuff..walked 2nd day,satrted pt 6th day..walked around Disneland 3 weeks PO..Teach ballet 11 hrs pr week....mostly full WB, but can't jump...subluxtion...anyway.. every one heals differently...so far I have had almost NO pain...so I assume I'm doing great...my PT seams to think so..my doc is impressed , but not concerned since I have no pain....I have conferred with others on this site with same things as me..and though I am further ahead, they don't seam too concerned either....only time will tell how it goes, but if you feel fine..I would continue as before.....just my 5 cents...

Hilde ;)
born with bad knee
83 patella ligament pierced by iceicle
84 50%  hamstring rip
86 lateral meniscus tear
more dance 
99 menisectomy(finally)
more dance
patellar & quad tendontis
05 LR, bonespur removal, general clean out, stage 4 OA
oct 06 illiophoas release( hip ok) but knee still bad...

Offline slash007

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Re: microfracture rehab gone wrong:(
« Reply #3 on: January 16, 2006, 06:56:44 PM »
Thanks for the replies.  My one hope stems from the fact that I don't have much pain or swelling at this time, but according to my doctor, even if the fibrocartilege grew like it should, there is a good chance that all of that hard focused jumping could have mashed it down since it was still fresh.  If so, it would wear out very soon and I will once again have pain.  What bothers me the most is that mentally I feel like my knee is a time bomb waiting to get very painful at any time.  I am just disappointed at my therapist for ignoring the OS orders and putting me through all that intense jumping.  I have had 7 surgeries already and this is the last thing that I need.  I was hoping to return to basketball soon, but now I just hope to be able to play with my kids when they get older:(

Offline blackbeltgirl

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Re: microfracture rehab gone wrong:(
« Reply #4 on: January 17, 2006, 03:50:58 AM »
Hilde - Microfracture is different from many other procedures.  The goal is to form a clot of scar tissue in a specific spot, so as a general rule, pushing it, even if you are able and not in pain, isn't the best path.  That said, Slash, don't worry too much.  I had microfracture just over a year ago, and was NWB less than a week.  My case wasw a very poor one for micrforacture (my lesions are WAY too big), and I think my OS hoped it would help long enough for me to lose some weight before more surgery.  Wish I had been consulted, but too late.  AT any rate, my point is, you seem to be doing very well.  Only time will tell if it worked, and how quickly or slowly it will wear out.  There are other cartilage repair/replacement options should you need them down the road.  As I said, I was walking in less than a week, and had full ROM within days.  At this point, use pain as your guide.  The fact that you CAN jump such a short time after surgery is amazing.  So if your PT shortened the life span of this fibrocartilage or not, you're doing well.  Enjoy it.  I'm sure there won't be such a miscommunication with this OS, for you or any other patient, again.
Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline momof4

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Re: microfracture rehab gone wrong:(
« Reply #5 on: January 17, 2006, 05:27:23 AM »
What a nightmare!  Unfortunately, communication often breaks down somewhere between the OS & Patient & PT--sorry you're on the short end of the stick--isnt' that the way it goes!

I had similar miscommunications & was up & walking within a few days of my microfracture.  Fortunately for me, I had some pain so I didn't do anything as strenuous as you.  However, since you've had little pain--go for it.  Enjoy your pain-free time with your knee--who knows how long it will last, but who knows how long any of us has, either (that was meant to be encouraging, but it sounds rather fatalistic.  oh well, it's late, sorry....)?

I'd recommend going back to PT & getting back to your top form.  Maybe your microfracture will last longer than you expect.

I've also not had the bone pain so many others have experienced, so I'm just hoping I'll never hear from that area again--at least not until I'm older.

Good luck to you & let us know how you fare.  Hope you're feeling better about it all.  Pamela

Offline slash007

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Re: microfracture rehab gone wrong:(
« Reply #6 on: January 17, 2006, 05:07:33 PM »
Thanks for the replies.  I have definatly regained a little hope.  The most heartbreaking thing for me is that alot of the reason for the extra activity is because I pushed myself to get back asap.  I am generally a fast healer ( I was playing bball 4.5 months after my last acl recon) and I was hoping to heal just as fast this time.  I'm really troubled that I probably ruined my microfracture after it has seemingly worked.  I gather from the info here that only 70 to 85% of microfractures actually work, so I feel like I was lucky enough to be from the ones that it worked for, only to crush it back down and waste it.  I guess only time will tell.  In the mean time, I plan on continuing my rehab and praying to God.  Thanks for the support.

Offline misshilde

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Re: microfracture rehab gone wrong:(
« Reply #7 on: January 17, 2006, 06:35:51 PM »
Slash & blackbeltgirl..sorry maybe I spoke too soon,,I don't know too much about different procedures to really comment..medically..but in general pain is a good indicater on healing and overdoing...also microfracture..what is it really??..my doc cleaned my patella track and broke the bone underneath to stimulate new "bone growth" is this the same???? I have chondromalica and OA really bad...but virtually no pain..so like you Slash I wonder if things are really working..but then again I am able to work out and do things that according to other peolple I "should not" do....
so now what..wait it out...???  patience is a virtue ??? ;D

Hilde
born with bad knee
83 patella ligament pierced by iceicle
84 50%  hamstring rip
86 lateral meniscus tear
more dance 
99 menisectomy(finally)
more dance
patellar & quad tendontis
05 LR, bonespur removal, general clean out, stage 4 OA
oct 06 illiophoas release( hip ok) but knee still bad...

Offline slash007

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Re: microfracture rehab gone wrong:(
« Reply #8 on: January 17, 2006, 07:04:51 PM »
Besides waiting it out, another thing that I am wondering is that will playing basketball once cleared by my doctor wear it out quicker?  I'm thinking that since I probably already wore it down with my erroneous rehab, will it be able to handle any bball at all?  If I was at this stage pain free and had confidence that it had a solid thick layer, then I wouldn't have any doubts about playing, but because of the rehab mishap, I'm really afraid to do anything sport wise, so I figure that is the biggest downfall of having been screwed by my PT.

Offline misshilde

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Re: microfracture rehab gone wrong:(
« Reply #9 on: January 17, 2006, 07:14:32 PM »
Hi, just looked up microfracture..guess I had a version of that..site says to stay off leg for 4 months..so I guess you messed up...but you never know..maybe you're superhealer..and it's too late to do anything about it..what's done is done..you must just be positive and hope..no think that everything is ok..and be patient!!! wish you best of luck and lots of 3 pointers and jumpshots to ya..

hilde
born with bad knee
83 patella ligament pierced by iceicle
84 50%  hamstring rip
86 lateral meniscus tear
more dance 
99 menisectomy(finally)
more dance
patellar & quad tendontis
05 LR, bonespur removal, general clean out, stage 4 OA
oct 06 illiophoas release( hip ok) but knee still bad...

Offline blackbeltgirl

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Re: microfracture rehab gone wrong:(
« Reply #10 on: January 17, 2006, 07:25:35 PM »
As Hilde said, since you can't undo the past, you might as well enjoy the future as much as you can.  Don't bother worrying about wearing it out sooner.  Hilde - I understand your perspective.  My current OS seemed a bit surprised I don't walk with a cane, considering the damage to my knee joint.  My pain levels (99 days out of 100) don't come close to my damage levels.  I'm actually proceeding with more surgery because of the risk of bone damage.  I'm only 31, and the treatment options if the bone damage gets bad aren't nearly as good as the options I have at the moment.

Slash - if you're up to playing basketball, play.  Yes, maybe you will wear out the fibrocartilage sooner.  But there's no way to know for sure.  And the point of having the surgery was to get back to your preferred sports and activities.  So enjoy playing, and if the pain comes back, you can decide how to proceed then.  I wish I'd been able to go back to tae kwon do, but while I'm not in pain for day-to-day life, tkd hurts, and it's too expensive to keep training if I have to modify everything.

Good luck-
Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline awoods11

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Re: microfracture rehab gone wrong:(
« Reply #11 on: January 17, 2006, 08:02:12 PM »
Your case was very similar to mine.  I thought I was going in for a torn meniscus and thought I would be back on my feet in a few weeks, like Ben Rothlisberger of the Steelers.  Anyway, after my procedure I woke up and was told my OS had a meeting and would not be briefing me.  I called his office the next day and talked to his assistant who basically told me to rest, ice, and elevate.  However, she said to weight bare at my own comfort level.  Of course I was trying to hobble around a few days later.  Fortunately, I had a follow up appt. about a week later and my OS told me about the Microfracture surgery and what it does.  I have been on crutches for 3 more weeks and feel like I can WB, but have been advised to the damage it can do.

Today my knee is a little sore, but I have really good ROM and am looking forward to rehab.  I was a former soccer player and have been in pain for years.  Thankfully I took up golf as my new sport, but prior to the surgery, I was running about 25 miles per week.  I guess this will not happen post op.

Luckily we have this website for advice.

GL in your rehab and recovery.


Offline slash007

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Re: microfracture rehab gone wrong:(
« Reply #12 on: January 20, 2006, 09:20:08 PM »
Just want to update-- for the past day and a half I have had pain in the lower outside area of my knee.  This is just what I was worried about.  Is it a normal pain assoc. with having this surgery done, or is my microfracture failing?  The pain started about 3 days ago but was barely noticable, but it has gotten progressively worse.  It still isn't too bad, but it does worry me.

Offline momof4

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Re: microfracture rehab gone wrong:(
« Reply #13 on: January 20, 2006, 09:30:59 PM »
SLash--wish I could look into my crystal ball & tell what the pain was.  FUnny thing is that we all have different pains since no two surgeries are EXACTLY alike and we don't heal exactly alike.

I had a pain on the medial side--turned out to be plica the first OS overlooked.  Hope yours is just transient and will disappear for you.  Good look.   

Pamela

Offline blackbeltgirl

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Re: microfracture rehab gone wrong:(
« Reply #14 on: January 20, 2006, 09:35:21 PM »
Is this new pain only when you're active, or do you feel it at rest too?  There are SO MANY possible explanations...  Give the knee a good rest, and some ice, and some anti-inflammatories, and if you don't think it's improving, call your OS.

Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)















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