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Author Topic: The Ups & Downs of Microfracture - Is this Pain OK?  (Read 24334 times)

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Offline cheeseheadproud

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The Ups & Downs of Microfracture - Is this Pain OK?
« on: May 08, 2012, 07:40:55 PM »
A quick history (ok, maybe not so quick):
I'm a 35 year old former college athlete (women's basketball & golf), who's life revolves around being active.  For the most part, throughout my life I have been pretty healthy, with no knee problems.
I injured my knee playing softball back in Oct. 2010 (collided with a large guy while running bases - ended up bruising ribs & hurting my knee).  After 2 weeks of knee pain, I went to a local OS who said it didn't look like anything major and to rest it & ice it for 2 more weeks and to come back if the pain didn't get better.  The pain got better and I spent the winter running & working out.  Softball season started again April 2011 and I went back to playing (no reason not to).  After the first couple games my knee starting hurting & swelling again.  Went to a different OS who did an MRI which showed a small defect on my femoral condyle - but what he thought was strange was that my pain was on the opposite side of the where the defect was.  He told me to rest for 6 weeks and see what happens.  Obviously at this point I was getting frustrated - there was something wrong with my knee, but no one seemed to want to help.  I waited 2 weeks and finally decided to seek out a specialist.  Being from the Chicago area, I turned to Dr. Brian Cole at Midwest Orthopedics.

One my initial visit he reviewed the MRI and thought the defect was small enough that I might be able to see successful results with 6 weeks of therapy.  Finally someone was giving me something to do to help.  I did 6 weeks of therapy and didn't see any major results.  At this point pain was not the major problem - it was the constant swelling and stiffness.  I went in for my follow up appointment and was given a surgery date - Oct 2011 (almost 1 year after my initial injury).  Unlike many of you, I was told they were going to do a scope, but if they found any issues, they would be doing microfracture - so I was able to prepare myself.

During my surgery they ended up finding not 1, but 2 defects - luckily they were pretty small (medial was the size of a dime and the lateral was a size of a nickel) and they ended up doing microfracture on both spots.  Yeah I was disappointed, but finally I had some answers and was looking forward to moving forward.

I used a CPM machine for 6 weeks, started PT after 2 weeks, was nonweight bearing for 6 weeks, partial weight bearing for 2 weeks, and finally at 2 months I took my first steps.  It was crazy to see how much my leg muscles wasted in those 2 months.  I continued PT 3 days a week for 4 months post microfracture.  At my 4 month follow up I was still experiencing quite a bit of pain, so I was given a cortisone shot to help calm everything down in my knee.  I was amazed at how much it helped.  I was finally discharged from PT after 4 months because I was able to do every exercise they were throwing at me with only a little pain.  I still hadn't been released from my OS (so no running, jumping, etc) and patiently waited until my next follow up.

1 Month ago (right around 6 months) I had my next follow up and was so excited to tell everyone I was practically pain free.  With that news I was finally given the ok to gradually return to activities - as pain allowed.  So I did just what they suggested - I gradually returned to activities, including running (20 seconds at a time - but it was still running).  2 weeks ago I took batting practice with my softball team and even did a little fielding.  The best part of it all - I had very little pain or swelling. 

There was absolutely no reason why I didn't think I could play in a very casual softball game last week (just shy of 7 months post op).  The first few innings everything felt fine - I was able to slowly jog bases and while I lost a few steps, I was still able to field.  I was just happy to be out there again.  Then in the 6th inning I was on 2nd and slowly jogged to 3rd (just like I had done the first 5 innings) but when I got to 3rd I felt a horrible pain in my knee - but I didn't remember doing anything to it.  The inning was over and I took a few steps to jog into the dugout and I about fell over in pain.  This pain was worse than I have ever felt in my knee.  I went home iced it, hoping it was just sore from overuse.

Unfortunately here we are 5 days later and I'm still experiencing pain and swelling.  I can no longer go up and down stairs without sharp pains, if I move a certain way I get shooting pains throughout my knee.  I'm really scared I messed something up.  I contacted my OS who said to ice it and take motrin or ibuprofen throughout the week (which I have already been doing daily) and see how it is.  I'm hoping it's just an overuse injury, but deep down I think it's something more.

Has anyone else experienced anything similar - where your knee felt pretty good after microfracture, you returned to activity and then something happened and pain came back (even worse)?  What was the outcome?  Also should I be concerned about pain in my non-microfracture knee or is that just from favoring my bad knee for so long?  Any help would be greatly appreciated!!       

Offline Seattlemark

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Re: The Ups & Downs of Microfracture - Is this Pain OK?
« Reply #1 on: May 09, 2012, 03:05:51 AM »
Hi Cheese,
Sorry to hear of your current setback. I too had micro fracture surgery at the age of 35, but on both knees 2 years ago (left in June '10 and right in July '10, both lateral). I was told to try and limit my weight bearing as much as possible but honestly I ditched the crutches within 3 days with each surgery. Basketball is my sport of choice with softball a close second. While I have yet to try playing softball since my surgeries (primarily due to not having a team to play on) I did try playing basketball about 7 months after my last surgery. After playing a few full court games over the course of a couple months, I could tell my muscles were not yet firing correctly (quads, glutes, etc). I too experienced moments of sharp pain or dull aching and swelling. So I chose to shut myself down and continue to self rehab. (No formal rehab was prescribed after the MFX though I had done plenty prior to surgery trying to avoid the knife). So I basically have continued to strengthen all of the major and minor muscles around the knee and of the legs. My left knee now feels remarkably good. My right knee, which was the worse of the 2, still has its moments (some swelling and stiffness) but has improved enough to where I have over the last 2 months returned to playing full court ball with little pain. I have not regained the leaping ability I once had and am told not to expect to regain that. However just playing again is wonderful though I religiously ice both knees after playing ( I HIGHLY recommend adopting this if you haven't yet).

Try and stay positive. Even 6-12 months after my surgeries I would go from days in which my knees felt fantastic and then without warning, one or both would feel like they did just prior to the surgeries. These changes would often come about without any increase in activity or clearly offending actions. I would get discouraged but regardless continued to ice and perform strengthening activities. I wish you luck and improved health.
6/25/10 - Partial lateral meniscectomy and microfracture lateral femoral condyle, debridement of patella and trochlea of LEFT knee

7/19/10 - Partial lateral meniscectomy and microfracture lateral femoral condyle, debridement of patella and trochlea of RIGHT knee

Offline cheeseheadproud

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Re: The Ups & Downs of Microfracture - Is this Pain OK?
« Reply #2 on: May 09, 2012, 08:36:49 PM »
Thanks Seattle!

Hearing your response makes me a feel better about the situation.
While the swelling has gone down a bit the past few days, the pain is still very much there.  The pain I have been feeling the past week is worse than it was prior to the surgery, which scares me.  I tried to do my normal Wednesday core training this morning and just being in the plank position shot pain through my knee.  I'm doing ok walking, but can tell I'm back to favoring my bad leg.

I'm hoping that this pain has to do with my leg muscles (or lack there of) and not anything else.
I'll keep you all posted.     

Offline Seattlemark

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Re: The Ups & Downs of Microfracture - Is this Pain OK?
« Reply #3 on: May 14, 2012, 06:04:51 AM »
Update needed. How's ya feeling?
6/25/10 - Partial lateral meniscectomy and microfracture lateral femoral condyle, debridement of patella and trochlea of LEFT knee

7/19/10 - Partial lateral meniscectomy and microfracture lateral femoral condyle, debridement of patella and trochlea of RIGHT knee

Offline cheeseheadproud

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Re: The Ups & Downs of Microfracture - Is this Pain OK?
« Reply #4 on: May 14, 2012, 07:55:04 PM »
The good news - the swelling has gone down significantly.
The bad news - I'm still experiencing quite a bit of pain.

I sent an update to my OS & his PA on Friday.  Almost immediately he told me I needed to come in as soon as possible for an evaluation.  Fortunately, his office had a couple of openings today.
During today's evaluation - it was concluded that I would need to have an MRI to see what was causing the swelling & pain.  The part that concerned me the most was that he not only wanted an MRI done to review my microfractured areas - he also wanted to check out my ACL.  It seems as though somehow over the past 7 months - my ACL has become 'loose' - he asked me repeatedly if I had twisted it or heard a significant Pop at any time - I told him besides therapy, it's been a pretty low key 7 months.  He didn't seem too concerned about the ACL, but still wanted to review it.  Guess we will wait and see.

My MRI and follow up are scheduled for next Monday.  I will keep you posted.

Offline cheeseheadproud

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Re: The Ups & Downs of Microfracture - Is this Pain OK?
« Reply #5 on: May 22, 2012, 08:44:55 PM »
So I had my MRI and met with my OS to review the results yesterday.

The first comments I heard was - oh Wow.

I guess I have what the OS and PA call a flare up.  There is significant edema (I believe that's what it's called) around my medial femoral condyle - one of my microfracture sites.
They said it's similar to a stress fracture and treated as such - 8/10 weeks limited activity (no running, no jumping, and no high impact activities)  I'm scheduled for another MRI on July 23rd to see if my knee has 'calmed down'.

Has anyone else experienced or heard of an flare up?

Offline Adobec

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Re: The Ups & Downs of Microfracture - Is this Pain OK?
« Reply #6 on: May 26, 2012, 04:48:23 AM »
I don't really have much help, but am interested in the topic.  I had surprise microfracture to my femoral condyle two months ago.  It has been such a mental battle! (I have already rehabbed 3 acl's and many meniscectomies/meniscus repairs).  My surgeon is a good friend.  He saw me in the office at my 6 week appointment and told me i was doing much better than expected -- that I could do whatever I wanted, allowing pain to be my guide. 

He also gave me "the talk" on how these knees needed to last me for a long time and that I would NOT be happy with a knee replacement (I'm 38).  He advised swimming, yoga, elliptical.  I was previously playing soccer and doing crossfit.  So after that appointment I went from swimming only -- to yoga (power/vinyasa yoga, so it's not walk in the park) most day of the week with swimming a few days per week.  I have tried the elliptical twice.

Anyway, my pain level has increased substatially.  I'm at the point where i makes me sick to my stomach.  I was at my doc's house last week and we were talking about it.  He didn't seem concerned.  He didn't tell me I was overdoing it or that he thought something was terribly wrong.  I got the picture that what I'm experiencing is quite normal to him. 

I have found this to be a true test of patience and faith.  I have four young kids who one year ago thought they had the coolest mom in the world.  Now they see me running for the couch whenever I get the chance :(
1991 - R ACL patellar tendon, med. meniscus removed (50%)
2002 - R ACL revision, cadaver, lat. meniscus removed (50%)
2011 - L ACL patellar tendon, med. and lat. meniscus REPAIR. 
3/2012 - L Medial meniscectomy (didn't heal from 2011), microfracture
11/6/12  - L TTT (maquet). Micro fully healed

Offline crewfan88

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Re: The Ups & Downs of Microfracture - Is this Pain OK?
« Reply #7 on: June 05, 2013, 09:28:05 PM »
I had a bad knee injury in high school soccer where was kicked hard on the inside of my knee, causing it to pop in and out.  This left me with sprained mcl, bone bruise and defect on the femur tissue.  I then required micro fracture, a year of rehab, and a second surgery because two pieces of cartilage from my meniscus was knocked loose.  It has been almost three years since the injury, I am 20 years old, and my knee is even worse.  I'm not sure what to do next.  I get constant pain, swelling, and stiffness.

Offline LegendaryCrossfit

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Re: The Ups & Downs of Microfracture - Is this Pain OK?
« Reply #8 on: January 13, 2014, 06:04:37 AM »
I had my microfracture after taking up long distance running at over 300lbs, I also started Crossfit and between the two sports lost 70lbs and the cartilage in both my knees. I had surgery on the left knee at the end of June 2011 and I was a model patient when it came to crutches (I got 2 extra weeks), PT and my knee brace. Here I am 1.5 years later and I still have a huge amount of pain and cracking noises. I did return to crossfit, though I stopped all impact exercises such as box jumps, running, jump roping and burprees. I stopped running in general except once in a while and those were always very short distances, and depended on how my knee felt. I waited 6+ months to return to activities. I worry that I will need surgery again and that terrifies me, it took everything from me, I gained weight and lost the things that made me happy- going through that again would be awful.

Offline Michalis

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Re: The Ups & Downs of Microfracture - Is this Pain OK?
« Reply #9 on: September 26, 2017, 02:35:55 PM »
I had my microfracture after taking up long distance running at over 300lbs, I also started Crossfit and between the two sports lost 70lbs and the cartilage in both my knees. I had surgery on the left knee at the end of June 2011 and I was a model patient when it came to crutches (I got 2 extra weeks), PT and my knee brace. Here I am 1.5 years later and I still have a huge amount of pain and cracking noises. I did return to crossfit, though I stopped all impact exercises such as box jumps, running, jump roping and burprees. I stopped running in general except once in a while and those were always very short distances, and depended on how my knee felt. I waited 6+ months to return to activities. I worry that I will need surgery again and that terrifies me, it took everything from me, I gained weight and lost the things that made me happy- going through that again would be awful.

Hi there,

How are you getting on? it has been sometime since your micro fracture.  Has it eventually healed? Do you get any pain?