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Author Topic: suprise microfracture?  (Read 1550 times)

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Offline hammo567

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suprise microfracture?
« on: August 25, 2006, 11:00:20 AM »
I went in for a meniscus repair and came out with a microfracture instead.  My OS sent me home with instructions to" use crutches the first 24 hours then WB as tolerated after that"  I was never given orders for PT and he told me later how he usually didn't "do knees" and that he was more of a back guy.  I am now 14 months post op and I still have significant "pop" and pain in my knee.  What should I do?????  I am at a loss as to what my next step should be.  I am afraid that going to a new OS will result in another surgery and I dread the thought of that.  Thanks for any help
Dutch
Micro fracture and Medial Plica removal: 6/14/2005                    4cm long x 1 cm wide medial femoral condole lesion and small articular lesion of the femoral notch region.  OATS procedure performed on 2/13/o8 on right knee. Pain back talking to surgeons 4/1/11 about allograft to fill in defect.

Offline stgiles16

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Re: suprise microfracture?
« Reply #1 on: August 26, 2006, 03:30:58 AM »
i am sorry to say, welcome to the surprise microfracture club. i went in for a menicus tear and came out with a surprise microfracture too. What part of the knee did you have your microfracture done on? If it was not a weight bearing area, then weight bearing is fine, if it on a weightbearing area, it is typical to be NWB for 4-8 wks. My first micro failed (it was on the medial femoral chondyle). I had it redone and was NwB for 6 wks, partial weight bearing for another 2 weeks then supposed to use a cane for 2 more months. This one worked. As for what you should do, that is up to you. Only you will know how painful your knee is and how long you can stand the pain. Microfracture is not a cure. it is a temporary fix that usually has a life span of 2-4 yrs. the life span is directly connected to how much and in what way that you use your knee. If the knee is in extreme pain, definately go see an OS, if it is just annoying, use your own judgement.  Just remember that the fibrocartilage will one day wear out and you will need a further surgery to correct this. did your OS not tell you any of this? I would seek out a different OS that specializes in knees when i decided to see another doctor.
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 hammo567

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Re: suprise microfracture?
« Reply #2 on: August 26, 2006, 04:53:20 AM »
the lesion was on the medial femoral chondroyle.  My OS didn't tell me anything except that he thought my best chance was a graft or future tkr.  I have a line on a new doctor in the Cahttanooga area.  He is a knee specialist and I am hoping he can help.  I am 33 with 3 children 7, 3, and 1 1/2.  My job was very physical and I had to switch due to this injury.  Thank you for the reply.  It helps knowing someone else is having these problems.
« Last Edit: August 26, 2006, 05:09:02 AM by hammo567 »
Micro fracture and Medial Plica removal: 6/14/2005                    4cm long x 1 cm wide medial femoral condole lesion and small articular lesion of the femoral notch region.  OATS procedure performed on 2/13/o8 on right knee. Pain back talking to surgeons 4/1/11 about allograft to fill in defect.

Offline Kai

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Re: suprise microfracture?
« Reply #3 on: August 26, 2006, 05:06:54 AM »
Excuse me while I go on a rant...   I dont understand what someone who is not a "knee guy" is doing messing around in a knee...  This is such a technically demanding and specialized area.. the fools who dont work with knees a lot cause so much misery.. and the ones that are good are so very very good.. and do so much to help so many..    As far as I know, the literature is still very inconclusive on the effectiveness of microfractures to begin with.. with many good people consigning the whole process to the quackery pile...   I am very glad that you are seeing a knee specialist..   and I wish those drs. that dont know what they are doing would spend 1 month in the chronic pain that they cause to patients...

OK.. end of rant..    and good luck with the specialist...   
ACLR - (patellar BTB autograft) left knee - May 31, 2006
Partial Lateral Meniscectomy right knee Feb 20, 2008
Partial Lateral Meniscectomy right knee Aug 11, 2008

Offline webber

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Re: suprise microfracture?
« Reply #4 on: September 04, 2006, 12:51:38 AM »
Oh it is so good to talk with others who have had a surprise microfracture. Mine was just supposed to be some torn meniscus, and I come out of surgery and find out I had two pieces, one lateral, one medical floating around in my joint space which could have caused me to land on my face going down stairs. Then I was also told, hey we did some microfractures. Some microwhat? Now I'm scheduled to be off work for 4 weeks instead of 1 and my boss is none too happy.

Offline Jaci

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Re: suprise microfracture?
« Reply #5 on: September 04, 2006, 01:08:07 AM »
Hello,

I mentioned this video a while ago on the microfracture board, but thought it might be benefical to post it again here.

A couple years ago, Dr. Steadman, the OS who developed microfracture gave a very informative talk on microfracture at an orthopedic conference. There is a video of the talk in the video library on Ortho Supersite.

If you want to take a look at the video, here is a link to the website:

http://www.orthosupersite.com/

Look for the "video library" near the bottom of the home page. It's in an orange box near the bottom in the second column of text. Click on viideo library and it will take you to several pages of topics. The video is called "Patterns of Articular Cartilage Lesions Amenable to Microfracture". You may have to look back several pages in the listing as new titles are added to the front. (I just checked and found it on page 6) I think you have to be a registered user to view the videos, but registration is free. It's a little hard to find, but definitely worth watching.

Two things that I found particularly noteworthy when I watched it-- 1) Dr. Steadman mentions that he wishes he would have copyrighted 'microfracture' to mean both the surgical technique and the rehab he developed. Far too many surgeons make up their own rehab protocol rather than following the much-published and successful protocol that he created. 2) Microfracture should not be performed as a surprise procedure as most people are not prepared for the sometimes intense and lengthy rehab involved to successfully recovery.

The talk is about an hour long. He discusses rehab about 45 minutes into it. He talks about the specific differences in rehab based on the location of the articular lessions. The 'no surprise microfracture' statement is made during Q&A at the end of the talk. Some of it is pretty technical, but I think it's worth while listening, after all he is the expert on the subject.

He uses a couple terms you may not be familiar with: DJD-- degenerative joint disease; Lysholm scores-- this is a knee assessment system

Best wishes for smooth recovery.

Jaci

PS-- Here's a link to some info on microfracture on the Steadman Hawkins clinic webiste:

http://www.steadman-hawkins.com/knee_microfracture/overview.asp
« Last Edit: September 04, 2006, 01:48:19 AM by Jaci »
10/03 Twist injury
12/03 Menisectomy- tears ACL, MCL, & LCL missed by OS
Arthrofibrosis ROM 38-68
3/04- 4/08 Multiple scar tissue procedures:
6 scopes w/LOA, AIR, LR, chondroplasty, synovectomy, bone spur & plica removal
3 insufflations, many injections
Chronic AF, patella infera, IPCS

Offline hammo567

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Re: suprise microfracture?
« Reply #6 on: September 06, 2006, 03:19:52 AM »
webber,
I would encourage you to look at the site from Steadman-Hawkins and make sure you get the follow up that is required.  I didn't have this board to lean on when I had my surgery and maybe things would be alot different for me now if I had.  Good luck and make sure you get the care you deserve and don't settle.
Micro fracture and Medial Plica removal: 6/14/2005                    4cm long x 1 cm wide medial femoral condole lesion and small articular lesion of the femoral notch region.  OATS procedure performed on 2/13/o8 on right knee. Pain back talking to surgeons 4/1/11 about allograft to fill in defect.

Offline stgiles16

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Re: suprise microfracture?
« Reply #7 on: September 06, 2006, 04:20:19 AM »
Every doctor has their own rehab for their patients and they can be very different. If you are unsure about your doctor's orders for you, I stronly suggest  that you call your OS and talk to him. Not every person needs to use Dr.Steadman's protocal. Some patients are even allowed to weight bear after their microfractures. My point is, you need to run your rehab by your own doc, dont just pull one off the internet and start doing it, you could hurt  yourself or cause more harm than good.

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 UofRSpider

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Re: suprise microfracture?
« Reply #8 on: September 06, 2006, 12:31:46 PM »
I went in for a meniscus repair and came out with a microfracture instead.  My OS sent me home with instructions to" use crutches the first 24 hours then WB as tolerated after that"  I was never given orders for PT and he told me later how he usually didn't "do knees" and that he was more of a back guy.  I am now 14 months post op and I still have significant "pop" and pain in my knee.  What should I do?????  I am at a loss as to what my next step should be.  I am afraid that going to a new OS will result in another surgery and I dread the thought of that.  Thanks for any help
Dutch

If you look down in the unicompartmental knee replacement section you will see where I had to go after an unexpected microfracture.  My new OS has no faith in microfracture (nor do I). Its funny...I actually could walk and run (a little) before the microfracture (which was supposed to be totally exploratory) and came out after surgery unable to EVER run again and needing a knee replacement.
October 2004 - Microfracture
May 2005 - PKR
October 2006 - Lateral release















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