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Author Topic: Has my microfracture failed? help!!  (Read 940 times)

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Offline michelel

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Has my microfracture failed? help!!
« on: November 16, 2008, 10:23:53 PM »
Hey yall im a 40 year old newbie to the forum.  i had microfracture surgery Aug13, 08, was NWB for 10 weeks.  My OS didnt mention the need for a CPM machine so i didnt use one.  I've been FWB for 2 weeks and every since, ive been in EXTREME PAIN YALL!!  i cant even walk right i have to walk with a severe limp.  I cant emphasize enough to yall how severe the pain is.  Has anyone had anything like this happen to them??  i did start PT just 2 wks ago, also started back to work 2 wks ago, i work third shift and i do have a lot of down time doing paper work, i'd say im up on my leg probably 4 hours out of 8.  After my surgery my OS told my husband my  knee was in terrible shape very very bad.  he said i would need a TKR within 10 years, and that i needed to loose weight.  i've been loosing weight, joined the YMCA, and have been swimming laps.  Again TERRIBLE pain, someone PLEASE help me. ??? ???
Right Knee:  1983 meniscal tear scope debridment &lateral release. 1991, 1997, 2001
2003 scope meniscal tears. 
8-08 MFX MFC lesion FAILED.
 4-09 Went in for OATS-not a canidate.
 6-09 Uni Right MFC.

Offline plantgeek58

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Re: Has my microfracture failed? help!!
« Reply #1 on: November 17, 2008, 05:24:34 AM »
you may just be putting too much pressure on your weakened leg all at once. From your post, it sounds like you went straight from no weight to full weight without anything in between. Then you added PT and work on top of that. If that's actually the case, it's no wonder your knee hurts. After 10 weeks NWB, your OS should have had you work very gradually up to full weight, over a period of several weeks and only putting as much weight on the leg as you could manage without pain.

As far as the job, I understand the need to get back to making a living, but, though 4 hours on your feet may not seem like much, it's an awful lot for a knee that's been through this type of surgery, especially when you're only just starting PT. When the muscles that support the knee are weakened from disuse, your alignment is off and that can cause pain.

As for the CPM, not every surgeon believes in them and some of us have recovered just fine from MF without using one. The important thing is to keep the joint moving. This stimulates the growth of the new cartilage.

I'm surprised your OS has left you hanging as far as rehab is concerned. This is a very delicate procedure and rehab has to be undertaken slowly and carefully for it to be successful. I wouldn't necessarily say that your MF has failed, though. It can be months before you get the full benefit of this surgery, because the cartilage takes a long time to mature. The pain you're feeling now could be caused by muscle weakness or by any number of other issues in your knee. You may find that as you progress with PT and your muscles get stronger, it lessens. In any event, I'd advise going back to your OS and letting him know what's going on. If he thinks its the arthritis that's causing the pain, then maybe you'll want to talk to him about hyalgan injections. They don't work for everyone, but some people have gotten a lot of relief from them.

Until you can talk to the OS, try to rest and ice your knee as much as possible. If you can't walk without limping, then I'd go back to using the crutches and putting partial weight on the leg. Limping will only screw up your other leg. As much as possible, try to avoid activities that cause pain.

I can't think of anything else to suggest right now, but if you want to learn more about other peoples' experiences with MFs, check out the post-op diary board. There are a number of us there with MF stories.
RK 7/04 part. m. menisc., plica resect., MF
    3/05 part. m. menisc., open OATS
    1/07 part l. menisc., MF, patellar chondroplasty
    9/08 MF
LK 11/04 & 8/06 part m. menisc.
     7/07 LR, patellar tendon debrid., part m. menisc.

Offline chondr1

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Re: Has my microfracture failed? help!!
« Reply #2 on: November 17, 2008, 06:24:48 PM »
I think your rehab protocol depends, to an extent, on the size and location of your chondral defect(s).  That being said, it does sound a little strange to have no PT and expect to go from NWB to FWB with so little reconditioning or strength building prior to that.  In my surgical experience,  I went from 2 crutches to one crutch (approx 30% WB),  precisely so that I would NOT limp.  I didn't lose the remaining crutch for another 2 months.  But look, you need to talk to your OS and revisit your rehab protocol.  Of course every OS does his/her own thing but if you feel you are doing something that differs significantly from a particular standard of care AND you're in pain, then it's time to reassess.  Furthermore, I think you are pushing yourself WAY too hard.  Being on your feet four hours a day at this point in your recovery seems really ambitious.  I know you may not have a choice but you have to find a way to take some of the pressure off your knee during that time.