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Author Topic: Mircofraction surgery or not?  (Read 1623 times)

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Offline irongirl

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Mircofraction surgery or not?
« on: October 27, 2011, 09:01:13 PM »
After two stress fractures in my tibia this year I went to a new sports doctor.  This doctor found the cause of my fractures; a patella cartilage tear.  He says I need microfraction surgery.  This recovery from this surgery looks very scary.  Currently I am walking fine...ok, sometimes I limp, but I can walk.  From what I've read it is a long road to walking after the surgery so I'm kind of nervous.  I know that the cartilage won't heal on it's own but does it get worse?  Is there anyone out there that felt ok before the surgery and after recovery felt great?  Is there anyone that choose not to have surgery?  Please let me know.  I'm extremely athletic and I hate the idea of loosing mobility.

Offline The KNEEguru

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Re: Mircofraction surgery or not?
« Reply #1 on: October 27, 2011, 09:11:23 PM »
I think you mean 'microfracture' surgery?
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Offline brianwith2ndknee

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Re: Mircofraction surgery or not?
« Reply #2 on: October 28, 2011, 02:10:03 AM »
I myself have been through the scenerio . I had my ups and downs for some time prior to surgery . I am a general contractor for a living and very active . I was a quick recovery after my microfracture and debridement ( 3-4 weeks after ) and fully back at it in 1 /12 months . Depending on the severity of your cartlidge defect , will determine alot on your own personal recovery . If you don't push your recovery and follow the rehab you should be fine . Have you had an MRI yet to look allitle deeper or just an x-ray or just a dr. guess ?
Knee Scope and Microfracture 03-2010
OAT's procedure , Reconstruction , Femoral nerve block 10-2011


Wishing everyone a healthy speedy recovery and good luck to all...
Brian S

Offline irongirl

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Re: Mircofraction surgery or not?
« Reply #3 on: November 01, 2011, 04:35:46 PM »
It is nice to hear of a quick recovery.  The MRI showed a hole in the cartilage down to the bone.   :(

Offline tobypaw

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Re: Mircofraction surgery or not?
« Reply #4 on: November 01, 2011, 05:28:32 PM »
I'm facing a similar decision. I had an MRI that showed a chondral lesion. Last week I had a scope to remove a loose body and to take a better look. My chondral defect is Grade 4, down to the bone and measures 1.5cm, bigger than the MRI showed. I also have wear on the adjacent  area of the patella. The surgeon mentioned Microfracture when I saw him after surgery but he wants to see how I do over the next few months. My cartilage injury is in a fairly non weight bearing area so there's a small chance that i can recover and have less/no pain.
I am also very active. I haven't been able to bike or run since I first felt this injury in August. The surgeon advised against running on a cartilage injury like this but says I should be able to bike, swim, yoga etc. I love to cycle and compete in races, so I think that will be the decider for me. If I can't cycle anymore, then I will look into Microfracture. Like you, the lengthy rehab freaks me out a bit. I was told about 2 -3 weeks NWB and about 6 months of limited activity. A lot depends on the location of the cartilage injury.
So I guess I will be int he category of trying to get by without the Microfracture surgery unless it is absolutely necessary. I will be asking a lot of Q's at my follow up. Esp interested to see if he thinks this will get worse (spread?) if I leave it alone.
:-)

Offline jt801

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Re: Mircofraction surgery or not?
« Reply #5 on: November 02, 2011, 02:01:32 AM »
The problem with articular cartilage injuries is that as you said, they do not heal on their own so more than likely your situation will get worse if you don't address it. There are many success stories with mfx, but unfortunately there are a lot of failure stories as well so it's hard to compare your particular situation to anybody elses. With that being said, it sounds like your damage is in a non-weight bearing area and that is in my opinion the greatest factor that contributes to whether mfx will be successful. If you read enough, the success stories of professional athletes who had good recoveries and returned to play at a high level involved NWB defects. I think you have that working in your favor but it's really your decision. Good luck!
12/99 left knee lateral release and plica removal
1/09 right knee chondroplasty and microfracture LFC

Offline vickster

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Re: Mircofraction surgery or not?
« Reply #6 on: November 02, 2011, 08:15:57 AM »
The problem with articular cartilage injuries is that as you said, they do not heal on their own

Mine did, ok with fibrocartilage rather than hyaline...on a full thickness 1.5cm2 defect in a WB area too...with no crutch use post injury (or indeed even any period of rest).  Seen during a scope that it is still well filled a year after injury (and as far as I can tell, 2 years).  I can certainly feel where the defect is, and there is clear damage to the subchondral bone underneath on the MRI, but it's no longer disabling

I think I must be weird as this does seem pretty unusual!  ;D

The location of the defect seems to play a big role - patella defects have a lower chance of repairing successfully due to the sheer forces, especially if there is misalignment,  It is important to know why the cartilage is damaged - mine was clearly due to trauma coming on my bike - but if wear and tear, the alignment should be checked which is why plenty of people have some sort of osteotomy with their cartilage repair.  Size also, I believe 1.5-2cm2 is on the cusp for mfx

All questions for the surgeon if you do go down that road
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline tnttracy

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Re: Mircofraction surgery or not?
« Reply #7 on: November 05, 2011, 12:02:04 AM »
I had MFX surgery Oct 12 (unexpected).  I am a very active-bike, swim, ski, waterski, mt bike, hike.  My left knee was acl deficient, prior menisectomy.  No pain until a more recent injury and then it was really only hiking over 3 hr or skiing that really bothered it. MRI showed another meniscus tear.  Was hesitant to have surgery but didn't want the tear to get bigger.  During surgery dr found 2 holes (<1cm2) worn to the bone and decided to do MFX. I woke up and was told 6 wk NWB!  Fixed the tear but not my acl  :'( Luckily it's my left knee and I can stil drive but managing on crutches sucks-I can't clean, vacuum, walk the dogs, it's hard to shower, get dressed etc. I have 3 more weeks but I can't tell you if it's worth it yet.  I have very little pain (since the first day), easy biking, floor exercises, I have almost full ROM. But it's very limiting!
hope this helps,
Tracy

Offline nursedeb

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Re: Mircofraction surgery or not?
« Reply #8 on: November 06, 2011, 12:07:27 AM »
Oh my God, please please dont get microfracture! I went in for a supposed meniscal tear, and I woke up to the horror microfracture. Before my surgery, I had intermitten pain and swelling. Not every day and not that bad. Since my surgery I have not had one day without pain, I walk with a limp and my pain is way way way worse. If you do your research, you will find that the majority of microfractures fail. The best knee surgeon at a major trauma hospital in Tampa told me that the majority of microfractures fail, and he doesnt even recommend. You would be better of looking into OATS or ACI, although they both have similar long rehabs, mixed results and they only buy you time before you knee a knee replacement. Personally, Im getting stem cell injections. The next surgery I have will be a partial knee replacement, none of this experimental stuff!!!















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