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Author Topic: Microfracture on 37 year old male soccer player  (Read 80233 times)

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Offline Scooter72

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Microfracture on 37 year old male soccer player
« on: July 26, 2009, 04:45:12 PM »
Hello to everyone in this forum!
My name is Scott, and I am a microfracture newbie.  I had my surgery done June 25th, on a non-weight bearing portion of the trochlear groove.  I would like to give some background, before I go into the experiences of my surgery and recovery (thus far).

-I am 37 years old

-Before my knee started giving me serious trouble, I played soccer or did resistance training five days out of the week.   I worked out my legs hard.. perhaps too hard, along with playing most of my soccer indoors.. on turf.  (Not good for the knees, I think, especially during collisions)

-I imagine, that like most people with cartilage damage, I have no idea what caused my injury.  I can tell you that I started feeling a bit of pain in my knee around September/October of 2008, and kept playing through the pain all the way through about March of ’09.  How stupid of me!  (I am stubborn when it comes to pain and injury)  I thought that the pain would go away by taking it easy.. maybe cutting back on leg exercises and how many games I played per week.  I started taking anti-inflammatory meds before and after each game.  Truth be told, the pain actually did vacillate in intensity, over  time.  There would be days where it wasn’t bad, or even non-existent.
But, eventually it got to the point where I started limping during games. I remember my last game, during which my teammates told me to quit for a while. (And they told me in not so kind a fashion.. which I deserved for selfishly inserting myself as a liability on the pitch)  They were right, and I didn’t argue, considering the pain I was experiencing.

-So I scheduled an appointment with my OS, who I must say is a class individual, although I wish I had pushed for an MRI much earlier. This guy was as conservative as can be.

  After  ruling out any kind of ligament damage, he put me on with physical therapy with the diagnosis of patellofemoral syndrome (which is very non-descript ).  He told me that he was pretty sure there was a tracking problem that may be solved with physical therapy.  Internally, I agreed because I have one leg that is 1/4inch shorter than another, and I imagined that over time, that would cause muscular imbalances, especially given my level of activity, that might lead to patellar tracking issues.  He also told me, “If it were my knee, I’d try everything and anything to avoid surgery of any kind.”  Now that is the  kind of doctor you want in any situation! One who cares about you, more than the procedure/money.

  I went to PT, and let’s just say that after two months, it did NOT solve the problem. (Side note.. don’t settle for a physical therapist with whom you are not satisfied.  Mine was gods awful in more ways than one, and didn’t care about me, so much as just getting through the session in mimimal time) I was still experiencing pain, and no amount of specific strengthening exercises was helping.

  I went back to my OS in May, and we decided an MRI was best.  The MRI revealed a suspected (and later confirmed) grade 4 defect in the trochlear groove.  At that time, I reached the point that many here do, in that I was tired of experiencing pain while doing simple movements.  Going up stairs, going down stairs, bending down to pick something up, trying to bowl.. I was angry at the situation.  So on with the scheduling of the surgery which was to occur June 25th.

-Now, I had a choice for my surgery; I could be put under general anaesthesia, or be given a spinal block, and be conscious for the surgery (paralyzed from the waist down, of course).  I chose the block, and watched the entire surgery on a monitor.  Quick side note:  My OS and staff were spectacular during and after the surgery.  We were telling jokes and talking about the procedure.  It was great, although I daresay I asked so many questions during the surgery, that I am sure my OS was close to having the anaesthesiologist put me under completely! Lol…

-During the surgery, my OS visualized the knee joint, and pointed out various anatomical references.  My meniscus and ligaments were in good order.. until he got to the lesion.  The lesion was indeed a grade 4, but small.  Maybe 1cm by 1cm, if that big. 
So my OS started to clean the area, and probed the cartilage on the periphery of the lesion.. oh NO! The cartilage is LOOSE.  There is a pause in the conversation at that point, and I knew exactly what he was going to tell me.  He would have to lift up the loose cartilage and cut it out, which he told me was not going to recover, and would eventually fall off and create a new lesion.  So he did.. and what was a small hole ended up being about 1cm wide by 1.5 inches long.  Thankfully, all of it was still in the non-weight bearing portion.  My OS told me that there was still a bit more he could have cut off, but his hope was that in doing the microfracture, the bit of loose cartilage would “reform its connection with the bone underneath”. 

-I went home that night, and my discharge orders said that I could be weight-bearing with the caveat that I avoid bending my knee, especially in the 40-70 degree range. The nurses that took care of me were so surprised that one of them double-checked with the OS. I wasn’t prescribed a brace to restrict flexion.  This was puzzling to me, because as you can imagine, even the most disciplined people are going to have a lapse, and accidentally bend their knee.  This happened to me, and when I called my OS’s office (after about the fifth time of bending), I was informed that it was “ok” to accidentally do so on occasion, and that they expected such to happen.

-The pain the first few days was annoying, but not unmanageable. Percocet helped a bit.  My knee was so wrapped up in dressing the first five days, that I could scarcely bend my knee, which in turn made walking a pain.  After I took the wrapping off at the end of the fifth day, the swelling and bruising was not too bad, by my subjective view.  However, I could not walk normally (i.e. without a limp) for another week.

-Right now, at 31 days post op, I can walk without much of a limp.. maybe a slight one.  I have the expected quadriceps wasting.  I have some swelling on the knee.  I have some odd pains, none of which are the intense “shooting pain” experienced by some here.  Well, maybe some of the pains I have had can be described as such, but it’s borderline.  My OS’s evaluation on Wednesday of this week (July 22nd) was positive.  He said I have two more weeks to wait before allowing me to resume normal activity, such as going up/down stairs, flexing knee under stress (right now, I am allowed to bend, but without stress), lifting weights etc… I will be going to PT at that time. 
However, there is one issue that is puzzling and disturbing to me, that I failed to address at my last doctor visit. When bending my knee (again.. under no weight/stress), I cannot flex past, say.. 110 degrees (assuming an unbent leg is 0 degrees).  At that 110 degree mark, I feel a lot of pressure on the patellar tendon,I think.  There really isn’t much pain.  I don’t really feel like it is locking, per se.. I just feel resistance.  I am wondering if anyone else has experienced something similar to this after a microfracture?

In any case, I know my first post is long-winded, but I certainly wanted to add to the tapestry of experiences here.  I am positive about the outcome of my surgery, and am sure I will resume soccer and weights at some point in the next three months.  Thus far, I haven’t experienced anything too troubling (other than what I just mentioned with range-of-motion).  I hope I can draw upon the strength of those who frequent this forum, as well as offer it.
Thanks!


« Last Edit: July 26, 2009, 04:51:47 PM by Scooter72 »

Offline Scooter72

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I want to add a bit more...
« Reply #1 on: July 26, 2009, 04:58:43 PM »
I am a strong believer in the effect of one's diet, upon life.  As such, after some research, I adjusted my diet to suit the repair process of my knee.  I just want to throw this out there, in case it helps anyone.

-I take a teaspoon of an omega-3 based fish-oil supplement.
-I take a teaspoon of a high potency cod-liver oil supplement.
-I take a vitamin D3 supplement.
-I take Cosamin DS 2x/daily.
-I eat fish at least 2x/week.
-I eat a lot of blueberries, cherries, and even grapes. 

I do take other supplements that are not directly related to repairing my knee, but the ones above are important, in my opinion.  Another note is that the supplements I take are not the "garden variety" one may pick up at the grocery; in my opinion, 99% of those are utter crap. 

Offline hungry

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Re: Microfracture on 37 year old male soccer player
« Reply #2 on: July 26, 2009, 05:32:35 PM »
Scott,

First off, welcome to the forum!

I have a small log I've posted on this forum as well (under Former College Basketball Player...) and had my trochlear groove microfractured on June 22nd. What surprises me most about your post-op is the immediate weight bearing, as well as you make absolutely no mention of using a CPM. As I had mentioned in my log, I was prescribed to be NWB for 6 weeks (although my surgeon has moved me up to PWB ahead of schedule) and I had used a CPM for 6 hrs/day. Hopefully you're surgeon prescribed some sort of passive motion for your knee in the post-op period.

Secondly, I'm amazed that you had the surgery performed with a spinal block, that's the first I've ever heard of! Great stuff, although I imagine it must've been tough to watch.

You also mentioned some pain in your patellar tendon. I've experienced the same thing, and my PT and OS have both suggested that it is simply as a result of the lack of quad strength. Nothing serious to worry about, and something that will go away with PT and strengthening. A

Another area you mentioned was that you had no idea how you're injury occurred in addition to having one leg shorter than the other. I am a firm believer that faulty movement patterns and muscles length/strength imbalances are what caused my cartilage defect. In my log I had mentioned that I had performed a functional movement screen which sought to identify and resolve these patterns and imbalances. After 2 1/2 weeks on the movement screen program I had even been able to play basketball with minimal pain. Having a functional movement screen (some may call it a Total Kinetic Chain Assessment as well) is something I HIGHLY suggest you look into before returning to soccer.

I also completely agree with you in terms of the influence of diet in one's life. Similar to you I had been eating a lot of fish as well as berries (I also tried to eat a more alkaline diet by eating a lot of spinach, raisins, etc.) but I think the biggest difference for me was drinking a gallon of filtered water throughout the day in addition to taking 3 caps of fish oil 3x per day. My knee has had minimal swelling and I think my diet has played a big part in it.

Finally, I hate to be a wet blanket, but I think a full return to sport by 3 months may be wishful thinking. From all I've read, most of the professional athletes that have had microfracture don't return to their sport for a full year, the newly formed cartilage simply takes too long to strengthen to the point where it can sustain heavy impact from sport to return within 3 months. In addition, many people on this board are still experiencing pain post-microfracture at 4-6months. Its my personal opinion that if you combine a quick return to soccer along with not addressing any muscle imbalances (which may have caused the injury in the first place), you may be setting yourself up for disaster. I know it really sucks to look at it that way, but I've started to develop the mentality that I've been living my life at a sprint's pace, but unfortunately the road to recovering from a microfracture is a marathon.

Nonetheless, I wish you the best in your recovery, and if you can make it back to soccer in 3 months without injury, all the more power to you!

David

Offline Scooter72

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Re: Microfracture on 37 year old male soccer player
« Reply #3 on: July 26, 2009, 08:22:43 PM »
Scott,
First off, welcome to the forum!
I have a small log I've posted on this forum as well (under Former College Basketball Player...) and had my trochlear groove microfractured on June 22nd. What surprises me most about your post-op is the immediate weight bearing, as well as you make absolutely no mention of using a CPM. As I had mentioned in my log, I was prescribed to be NWB for 6 weeks (although my surgeon has moved me up to PWB ahead of schedule) and I had used a CPM for 6 hrs/day. Hopefully you're surgeon prescribed some sort of passive motion for your knee in the post-op period.

Thanks for the welcome!
No, my doctor did not prescribe any kind of passive motion for my knee.  Before the surgery, I even asked him about that; he said there was no need to weight-bearing restriction or a passive motion machine.  Odd, eh? 

Quote
Secondly, I'm amazed that you had the surgery performed with a spinal block, that's the first I've ever heard of! Great stuff, although I imagine it must've been tough to watch.

Yeah, that was interesting , to say the least. But it also allowed me to develop great trust with my OS.  I saw everything he did, and while I am (obviously) not an expert, I think he took care in the placement of the holes, and with how much loose cartilage he took off.

Quote
You also mentioned some pain in your patellar tendon. I've experienced the same thing, and my PT and OS have both suggested that it is simply as a result of the lack of quad strength. Nothing serious to worry about, and something that will go away with PT and strengthening.

It’s not the pain that is troubling; it’s the tightness, that comes with trying to flex it past 110 degrees (which I can’t do, or at least won’t push myself to do for fear of injury).  I just want to know why I can’t flex past this point, and how to get past it.

Quote
Another area you mentioned was that you had no idea how you're injury occurred in addition to having one leg shorter than the other. I am a firm believer that faulty movement patterns and muscles length/strength imbalances are what caused my cartilage defect. In my log I had mentioned that I had performed a functional movement screen which sought to identify and resolve these patterns and imbalances. After 2 1/2 weeks on the movement screen program I had even been able to play basketball with minimal pain. Having a functional movement screen (some may call it a Total Kinetic Chain Assessment as well) is something I HIGHLY suggest you look into before returning to soccer.

I read your log, and I am comforted by the suggestion.  It makes sense.  But I wonder how, after just 2.5 weeks on the program, you are able to play with minimal pain?  Could you elaborate on the technique(s)? 

Quote
Finally, I hate to be a wet blanket, but I think a full return to sport by 3 months may be wishful thinking. From all I've read, most of the professional athletes that have had microfracture don't return to their sport for a full year, the newly formed cartilage simply takes too long to strengthen to the point where it can sustain heavy impact from sport to return within 3 months. In addition, many people on this board are still experiencing pain post-microfracture at 4-6months. Its my personal opinion that if you combine a quick return to soccer along with not addressing any muscle imbalances (which may have caused the injury in the first place), you may be setting yourself up for disaster. I know it really sucks to look at it that way, but I've started to develop the mentality that I've been living my life at a sprint's pace, but unfortunately the road to recovering from a microfracture is a marathon.

No, I do understand, and even agree with your assessment.  I am not experiencing any significant pains right now, but I also consider that under my current restrictions (which last for another two weeks), I am not even allowed to lift trash can with my knee bent.  So what is going to happen when I try to bend my knee, or run?  Will I experience a lot of pain? I don’t know. 
Considering the fact that I wouldn’t have undergone the surgery, if I didn’t love soccer so much, I’d rather be guarded during the recovery process.
Now, where do I get a functional movement screen?  And how long do I wait to get it?  Surely, at least until some time after the six-week period.

Offline hungry

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Re: Microfracture on 37 year old male soccer player
« Reply #4 on: July 26, 2009, 09:43:31 PM »
Scott,

With regards to the patellar tendon tightness, I'm sort of in the same boat as you. Although I'm able to go to about 130 degrees, I still do feel the tightness in the tendon itself. In my case, I feel its caused by some residual underlying swelling, but my ROM gets better everyday with light stretching. For you I would also suggest some stationary biking. Put the bike to zero resistance and pedal away, this will help bring blood to the area and is within accordance of your post-op rehab. Just going through that ROM will help loosen up some of the tightness.

I'll do my best to explain the functional movement screen here.
The FMS is a series of tests to determine where your muscle strength/flexibility imbalances lie. For many of us, because of the way our society is structured, we will have issues with out hips and thoracic spine which will lead to injuries of the knees and lower back. How would something like tight hips lead to a knee injury? To quote a recent article:

"Tight hips will lead to forward trunk flexion, when an athlete lands from a jump, instead of keeping their trunk upright and parallel to their lower leg, their chest collapses toward their knees. When the athlete’s trunk flexes forward, they lengthen the gluteus maximus, which forces the hamstring to eccentrically control the lower leg and the loading of hip flexion. This results in a faulty movement pattern which causes stress at the knee.”

The body itself is an intricate system, for example if you have perhaps sprained your ankle in the past and thus its ROM is impaired it will affect the knee as well. To quote again:

“Let’s say it’s the right knee that’s bothering an athlete,” Clark says. “In many cases, we see that the left ankle is restricted. If an athlete jumps for a rebound and lands, the dorsiflexion when landing from a jump needs to be at about 15 degrees. But many NBA players we see only have five degrees of dorsiflexion.

"If their ankles don’t bend, their knees must deal with the force," he continues. "And the next joints up from the knees are the hips, then the spine. When they land, they have to shift the weight over to their right and their right knee takes most of the eccentric load, and you get shear, compressive force on the joint that creates trauma.”

Can you see how all parts of the body are interconnected? Many times people think that because they have a problem with there knee that they need to focus the rehab solely on the knee... While this may work some of the time, most often you are just treating the symptoms rather than solving what caused the problem in the first place (which is a HUGE issue in medicine today).

As for my experience with the FMS? I had many issues which needed to be dealt with. Top to bottom. I had poor range of motion throughout my Thoracic spine and tight lats which pulled my center of gravity forward. I had a weak intrinsic core which forced my knees and low back to absorb a lot of the stress from basketball. My hips were just god-awful terrible, they were ridiculously tight which not only pulled me forward but also inhibited my glutes (which are an incredibly important in becoming a good athlete, if you have inhibited/weak glutes, you wont be a good athlete). Finally I had poor ROM and proprioception with my ankles as a result of years upon years of cumulative ankle sprains.

I had followed the program very diligently for 2.5 weeks, doing it 6 times a day (I had 10 years of basketball injuries built up, I really had no other choice than to make a drastic change). After following the program and just before my surgery, I decided to give basketball another go around. The difference was huge. In the past, every move, cut, sprint, and jump required a ton of energy; after everything felt much more fluid and effort-less. In the past, I had a lot of trouble staying low to the ground on defensive slides and drives, after I was able to get into and stay into these positions easily and I was much quicker as a result.

Obviously I could go on and on about the FMS but I'll cut to what you want to know.
I had the FMS done by a certified kinesiologist and personal trainer at my chiropractic clinic. You are going to have to ask around where to find one, your physiotherapist or surgeon will likely know where to have one done.
When should you have it done? Ideally, you should have had it done before your surgery. However, it will be best to have it done when you are comfortably able to squat and lunge with your own body weight (there should be NO pain), which for most seems to be around 4 months post-op.
Finally, the screen works like this: You will perform the tests while being video taped. The person performing the screen will analyze the video and determine your weaknesses. From there they will build a corrective exercise program for you to follow. My program took me about 90minutes to complete, but got easier and faster as I progressed.

Also, if you want an in-depth read about the screen itself, I suggest you give "Athletic Body in Balance" by Gray Cook a read.

Let me know if you have any other questions and good luck!!

Offline madel23

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Re: Microfracture on 37 year old male soccer player
« Reply #5 on: July 27, 2009, 12:32:15 AM »
Hey Scott,

I am athlete who had a mfx of a small lesion in the trochlear groove as well.  My advice to you is to be patient.  Originally my OS told me I'd probably be better in 3 months (because I'm young), but when that didn't happen he revised it to 6-12 months.  Don't do ANYTHING that causes pain, even past the 6 week mark.  I started pushing things a little then and now I'm worried I did some damage.  But only time will tell.  At 5 months post op, some activities hurt less than pre-surgery, but others hurt more.  And I have not been able to return to my sport yet (distance running).  Also, I would try to get some massage therapy to loosen up your lateral quads and IT band, as tightness there could possibly be causing your problem with flexion.  I've had some problems from pain with passive flexion as well, but massage seems to help.

Offline John1

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Re: Microfracture on 37 year old male soccer player
« Reply #6 on: July 27, 2009, 04:56:29 AM »
Having a little extra fluid in the joint will cause it to not flex completely. That is because the joint capsule has the most volume at 30 degrees of flexion. If you try to bend it more there is less volume, so any extra fluid will be trapped and prevent it from bending.

Did you have loose quadriceps before you developed pain? I ask because in my case I think having tight muscles contributed to my cartilage getting worn away. If your muscles are tight and you sit with your knee bend then the extra pressure on the cartilage makes it lose it's elasticity for a few hours. If you run around and play on it, then the cartilage will be vulnerable to damage.

I'm not sure if it's a good idea to even be trying to bend your knee that much so soon after the surgery. You definitely want to get the flexibility back, but I don't think it's a good idea to put pressure on the microfracture location by stretching it hard. You can try to get the extra fluid out by flexing your quadriceps repeatedly with you knee straight or by riding a stationary bike. The knee joint drains through the lymph system which is driven by muscle contractions. It's a matter of flexing your quadriceps without putting too much pressure on the microfracture spot.

If it's not fluid causing the lack of flexibility, then it could be some scar tissue in which case you need to balance the stretching with the risk of damaging the microfracture. If the doctor says that is not a concern then I guess you have to go with what he says.
4/12/05 Arthroscopy: plica removal and medial femoral condyle microfracture (2 cm^2)
11/9/05 Arthroscopy: complete removal of plica, removal of scar tissue on fat pad behind patella tendon and on medial side.

Offline Scooter72

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Re: Microfracture on 37 year old male soccer player
« Reply #7 on: July 27, 2009, 08:11:35 AM »
  David, I will definitely be getting an assessment when I am in a safe zone, which at this point is looking more like it will be months, not weeks, before I can do so.  (I.e.,I am not jeapordizing anything here)  In the meantime, I really plan on using you and others here as an anchor.  Maybe emotionally/mentally as well as for knowledge.  I am thankful to have met you all.

  Madel, I thank you for your advise, and sympathize with you a lot, because gods know that distance running is potentially worse on the knees than soccer, or basketball. But I am confident, after having read some of your posts, that you will persevere. A common theme that recurs with people posting their microfracture stories, is that it's also a huge mind game.  Unless you are on the verge of having your leg amputated, don't believe anyone that hints that you may not be able to return back to your previous running levels.
  As for not doing anything that causes pain.. that is a bit subjective, I hope.  Because if I were to take you literally, I'd be lying down all day, strapped to a bed. Right now, I welcome the dull pains, and testing my ROM in association with such pains, because it tells me where I am at.  Keep in mind, I am doing such testing with care.  It's not as if I am squating weights (even my body weight), or attemtping to pick things off the ground by bending my injured knee; I usually take care to place any torque/pressure on my good knee, even when performing the most mundane of motions.
  John, there was NOTHING loose about my legs, prior to injury! Lol.. I had ultra tight eveything (including quads).  It was so bad, for the very reason I am in this predicament now.  I surmised that one day my tight legs would get me into some kind of overuse/unbalanced injury trouble, but didn't do anything about it.  Part of the reason was, and I know this will sound strange, due to the "spring" that having tight leg muscles would give me, when I was sprinting.  I can't describe it any beter than that.
  As for damaging the mx location; that is in the 40-70 degree area.  I cannot bend my knee much past 110 degree.  Now obviously, I have to get past the 40-70 to get to the 110-120 degree area, but I do it lying in bed and slowly bending my knee.  I don't dare do it standing up, or placing any excess force upon it other than what it takes to stretch it a bit past the "tight" point, which is again, well past the ROM that the mx injury is contained within.

One thing I am curious about though, is why you and David suggest riding a stationary bike, which would naturally hit that 40-70 degree area?  My OS suggested the same, using zero resistance (as you two have noted).  But, it runs contrary tothe whole "don't bend your knee too much" advice.  Riding the bike wold do so with great frequency.


Offline madel23

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Re: Microfracture on 37 year old male soccer player
« Reply #8 on: July 27, 2009, 01:33:21 PM »
Hey Scott,

I think the dull pains when you are walking around or whatever is ok.  It's the sharp stabbing ones you want to avoid.  Also, I didn't have a CPM machine or leg brace after surgery, and while I can't tell you whether that was a good idea yet, just letting you know there are other OS's besides yours who do not prescribe those. 

Offline John1

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Re: Microfracture on 37 year old male soccer player
« Reply #9 on: July 27, 2009, 06:43:28 PM »
One thing I am curious about though, is why you and David suggest riding a stationary bike, which would naturally hit that 40-70 degree area?  My OS suggested the same, using zero resistance (as you two have noted).  But, it runs contrary tothe whole "don't bend your knee too much" advice.  Riding the bike wold do so with great frequency.

The stationary bike will help get any excess fluid out of your knee. Of course, you don't want to over do it on a high resistance.

Another reason is that the movement is actually good for the cartilage growth. The mesenchymal stem cells that come from the bone marrow onto the microfracture site can differentiate into fibrous cells, cartilage cells (chondrocytes) or bone cells (osteoblasts). This differentiation is partial determined by the amount of stimulation given to them. If I remember correctly, less stimulation results in osteoblasts, more results in fibrous tissue and in the middle makes chondrocytes. The problem is because there is never equal amounts of stimulation to all parts of the microfracture site, you can never end up with all cartilage. You typically end up with a layer of cartilage cells near the bone, but fibrous tissue near the surface. I never came across any definitive advice on exactly how much movement a patient should do the get optimal results, but doctors seem to advise doing the stationary bike because it's low impact but will get the fluids in the knee sloshing around to help stimulate the healing.

I think they don't want you to bend the knee with your weight on it, but bending it on the stationary bike won't put much pressure on the cartilage, so it is OK.
4/12/05 Arthroscopy: plica removal and medial femoral condyle microfracture (2 cm^2)
11/9/05 Arthroscopy: complete removal of plica, removal of scar tissue on fat pad behind patella tendon and on medial side.

Offline hungry

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Re: Microfracture on 37 year old male soccer player
« Reply #10 on: July 27, 2009, 09:08:42 PM »
Very well put John!!  ;D

Basically, passive motion = a very good thing for recovering knees!

Offline Scooter72

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Re: Microfracture on 37 year old male soccer player
« Reply #11 on: July 30, 2009, 07:10:42 PM »
I just wanted to give an update on how I feel.  This is week 5 for me.  I still have some aches and pains, but they are not troublesome by any means. I can straighten my leg easily, without pain, while sitting in a chair. There is some cracking, and occasionally my knee cap will “click”, which it did before. Of course, I have yet to really test my knee with some serious weights/resistance training (which I would start off lightly).
However, I have cheated a bit, and carefully, slowly tried to go up my basement stairs, which are about eight inches tall for each stair.  I didn’t have any problems with pain in doing so, except going up the stairs at a certain angle, that bothered me before the surgery.  I know it’s hard to visualize, but imagine going up stairs, while holding your  back and head straight (i.e. perpendicular to the ground), so that the full weight of your trunk and head is erect.  The good news is, that it doesn’t hurt nearly as badly as it did before the surgery.  If it keeps the same pain level with more vigorous activities, I will be happy.. but that remains to be seen.
The bad news is that my left leg (the injured one) is so very weak.  Going up stairs required a lot of effort and the stabilizing muscles are clearly out-of-whack.  I can tell that at this point, I couldn’t even jog if I wanted too.  In fact, I am willing to bet that I will have to re-learn how to run.
Furthermore, I cannot yet go down stairs.  I’ve prepared to try it, but each time, as I was about to step down (using my injured knee), I could easily tell that the muscles necessary to complete the motion were just weak.. as in, if I had tried to step down, it would not have been a controlled motion at all. 
My range of motion has improved, but I still do not have full flexion.  I am confident that it will return with time, but I won’t push it.
I do have PT starting next week.  My OS said that the PT won’t be “easy”, as in I will be motivated to really work the knee, but of course, without injuring it.  That’s going to be an interesting line to explore, since I have a natural  tendency to be impatient with these matters.
I hope some will take heart with my experiences so far.  I believe the microfracture will work for me, but only with time and proper care of the knee.  I don’t think that the knee will be the same, but honestly believe that I can return to the same level of performance I one enjoyed, on the field.  It may take an incredible amount of work, but I was committed to such the second I accepted this surgery.

Offline Scooter72

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freaking ouch!
« Reply #12 on: July 31, 2009, 05:32:34 PM »
So, I think I pushed my knee a bit too far last night. I was running it through a range of motion test.. one that I made up on my own.  While my ROM is better, because I can bend my knee further than was possible, even four days ago, the fact is that I still have pain when using my leg in the positions/angles that caused pain before.  Of course, the pain occurs with resistance. 

That's ok though, I am guessing that this is normal (since I am only at week 5).  I think I'll take it easy until I go to see my physical therapist next Friday. 

I will be so glad to get something going.. anything.  My exercises routine has been nearly non-existent compared to what I am used too, and I am very antsy over the umm.. "body change" that has resulted. Lol! 

Anyway, if I can offer any assistance to people here, please feel free to hit me up with questions. Thanks!

Offline Scooter72

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Hmm.. the pain is still there...
« Reply #13 on: August 02, 2009, 06:40:54 PM »
I am four days away from being cleared to do rehab (through a PT), which will include a vigorous weight schedule, I am guessing.  So, I decided to test my knee a bit early, and attempted a reverse lung, in a slow, controlled matter.  The reverse lunge happens to be one of the moevement types that caused a lot of pain.

The good news, is that I made it through the lunge..

The bad news is that it feels almost as bad as it did before the surgery.

So, of course, I am wondering if the procedure was a failure and/or if I somehow caused this.

I know that the defect is likley not filled in and "mature", but it's still disconcerting, and leads me to consider that it is a failure. I would think that an initial layer of fibruous cartilage would have been layed down in the defect.

If it is a failure, I will wait a while, strengthen my leg as much as possilble and play soccer as I can, until I can decide on another course of action.

One possibility is called articular cartilage paste grafting, whihc is done at the Stone Clinic. This procedure results in a much better repair cartilage that is mostly hyaline in nature.

Offline PieceDesigner

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Re: Microfracture on 37 year old male soccer player
« Reply #14 on: August 02, 2009, 07:14:37 PM »
Hi Scooter. I had my surgery the day before you did.

I had MFX in the trochlear groove, and MFX & TruFit plug installed in the medial femoral condryl. Since the most serious injury was to a weight bearing area my rehab is much slower than yours. I just started PT Friday. I am not completely off crutches or cane yet.  My rehab is mostly ROM work now. I am OK with slow and steady. Would rather err on the side of caution than go through this surgery again!  I have a long ways to go to build my muscles back.

I cringe when I think of the pain you must have after attempting that lunge!  :o   I would think the MFX would still be very fragile at 5 1/2 weeks.?? I'm thinking it's would also be too soon to know if it was a success or failure. What is your OS saying?

Take it easy until you see you PT this week.  This journey does try one's patience, doesn't it?   ;)

Nan