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Author Topic: has my micro-fracture failed?  (Read 10966 times)

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Offline rob43

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Re: has my micro-fracture failed?
« Reply #15 on: February 15, 2012, 05:54:48 PM »
should i still be iceing the knee before and after exercise still 5months after the op?

Offline vickster

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Re: has my micro-fracture failed?
« Reply #16 on: February 15, 2012, 06:03:53 PM »
If it is swollen and/or sore, yes I should think so  :)
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 dm

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Re: has my micro-fracture failed?
« Reply #17 on: February 16, 2012, 07:06:28 AM »
If you're still having swelling problems, then icing certainly won't hurt. After my knee was re-imaged and they determined my mfx failed, they wanted to do a cartilage graft, but I have refused because I have other issues to take into consideration, that I contend make the graft a bad idea. Plus, for me, I can't spend 3months on crutches and out of work , and extensive rehab. My knee's so messed up as it is, I'm just this side of a replacement anyway, even at 40. the thing is convincing them of quitting playing around and torturing me with "stopgap" measures and messing with my quality of life and just doing it. I'll worry about not being able to walk when I'm 70, if I live that long. There's all this crud in the news about painkiller use and addiction etc, yet I have no choice but to keep them on hand, I can't walk without pain.

multiple arthroscopies 2/00,3/01,6/01,1/03, 12/07,10/10. chondromalacia, severe medial joint space narrowing following 3 partial menisectomies, chronic pain problems, kneecap problems, OCD lesion, failed mfx.

Offline rob43

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Re: has my micro-fracture failed?
« Reply #18 on: February 16, 2012, 10:21:35 AM »
dm i understand where your coming from ive been off work over a year now cant afford to live as it is, i go to sleep thinking about my knee ,wake up and its first thing on my mind
i have stress and depression due to not being able to live my life at all.7
my life is sport if i,m not teaching i,m playing football or jogging etc
hardly been outside the frontdoor in a year now!
i am 43 and feel like i,m 90 the physio is a ignorant twat who doesnt listen at all, the surgeon is never there when you ring just answer phone all the time
fed up with it all

Offline vickster

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Re: has my micro-fracture failed?
« Reply #19 on: February 16, 2012, 10:35:43 AM »
Rob - have you spoken to your GP about your worries and concerns?  Perhaps they can refer you for some counselling or CBT whcih can help you refocus.  Or indeed chase up the surgeon more forcefully, refer you to a different physio department (GPs sometimes have in house physio) or even to a sports medicine consultant or a different OS - sometimes knees just need a fresh pair of eyes (worked for me when I found a different physio).  You are in Middx IIRC, there is the world class Royal National Orthopaedic Hospital in Stanmore which cannot be too far away.  If you don't like one GP, ask to see another.

Are you a PE teacher in a school or a private coach?  If the former, does the school/education authority not provide any type of support along the lines of counselling?  Are you on disability benefits etc, if so, perhaps that entitles you to help?

When did the trauma to the knee actually happen?  Have you had problems for a long time?
« Last Edit: February 16, 2012, 11:02:39 AM by Vickster »
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 rob43

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Re: has my micro-fracture failed?
« Reply #20 on: February 16, 2012, 02:31:02 PM »
thank you for
 all the kind support
i had physio again today i told the physio my concerns and said that i dont think the micro had worked
all he did was look at my knee twist it around a bit i said can you feel the clicking etc he said yes but its not that bad, does it hurt? i said yes
his reply was oh ok well i think its coz your muscles are too weak, i replied by saying well my muscles are weak because my knee hurts his answer to that was( well)! go over there on the weight maching and do leg press and leg extension
so he isnt listening to me at all!!!
i am going to ring the doctor and arrange an appointment as for the stanmore hospital your right it is only up the rd about 10miles from me!
i thought i had one of the best surgeons as it was in matthew barlett

Offline vickster

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Re: has my micro-fracture failed?
« Reply #21 on: February 16, 2012, 08:09:24 PM »
The surgeon's skill may not be at fault - often mfx just doesn't work - I believe it's because people just don't develop fibrocartilage to heal

Hope you can see someone at Stanmore, they are very experienced in cartilage repair, although that really is one tough surgery to get over

The physio certainly doesn't sound especially helpful, especially given your goals - a private sports focussed physio would be the way to go if you can
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 rob43

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Re: has my micro-fracture failed?
« Reply #22 on: February 18, 2012, 03:56:03 PM »
if this has failed,what options are there to repair this i dont really fancy having another mfx the recovery time is so slow

Offline vickster

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Re: has my micro-fracture failed?
« Reply #23 on: February 18, 2012, 04:05:39 PM »
How large was the defect and where?

The other main options are profiled here - note, they are all pretty much open surgeries and the success rate after failed mfx is reduced.  The surgeon at Stanmore should be able to advise if you get referred

http://www.kneeguru.co.uk/KNEEnotes/node/1839  (note ACI is usually the MACI type in the UK)

This is quite a good link too on (M)ACI

http://www.kneeclinic.info/download/CKC_GNHFT_ACI_RehabGuide_101106.pdf





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 rob43

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Re: has my micro-fracture failed?
« Reply #24 on: February 18, 2012, 05:24:55 PM »
lateral side of knee, about size of a thumb nail think the sugeon said roughly 1to 1 and a half cm no idea if this is big amount or not?

Offline vickster

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Re: has my micro-fracture failed?
« Reply #25 on: February 19, 2012, 03:44:19 PM »
Mine is around 1.5cm2 , not a small defect but not big, there are people with far bigger ones out there.  I think probably as big as you would want to microfracture, ok for OATS (although again better for smaller defects as you don't want to be taking to much cartilage away elsewhere in the knee I guess), probably on the small side for MACI.  Location and how it affects you personally, is as influential as size.  I think another MRI is the only wat to know if the fix has failed, and even then imaging isn't foolproof

Did you have a specific injury or is this wear and tear - apologies, I can't recall  :)
« Last Edit: February 19, 2012, 03:47:00 PM by Vickster »
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 rob43

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Re: has my micro-fracture failed?
« Reply #26 on: February 19, 2012, 04:50:53 PM »
football injury i just bend down on the left knee during a game and felt it tear wasn't tackled or anything
strange thing is when i start to exercise it hurts a lot and my leg muscles dont seem to work, then after a few mins my muscle seems to wake up the pain goes off and i can then do leg extensions etc,but once i stop for an hr or two i,m back to square one and same again
so is this because the knee isnt right? or the weak muscles that need time to get strong again?

Offline vickster

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Re: has my micro-fracture failed?
« Reply #27 on: February 19, 2012, 04:59:19 PM »
Well I'm no expert but from what I gather muscle strength is very important - and I doubt any surgeon will operate (on the NHS) if he feels there is a muscle weakness, particularly given what you describe.  A MACI repair costs upwards of £10k (2 operations, 6-12 months of serious rehab) and the criteria on the NHS are strict but certainly it is worth seeing someone else if you can 9a surgeon may not be keen to see you until you are 6-12 months out of surgery).  Are you building up leg strength on the bike - 10-20k with some resistance is, imo, better than doing some weights - and much less impact.  How do the muscles actually look and feel - is the leg much skinnier than the other?

Have you seen the GP yet?  I'd be trying to see a different PT too given your current one isn't being much help - have you explained this to him?

In terms of physio exercises, I found SLRs and wallslides to be most useful - every night
« Last Edit: February 19, 2012, 05:00:51 PM by Vickster »
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 rob43

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Re: has my micro-fracture failed?
« Reply #28 on: February 19, 2012, 05:30:22 PM »
i dont do much on the bike as ive had major back op 3times and the bike tends to upset my back
i do wall slides offen but it hurts my knee i cannot put full weight through my foot and push off yet
as for size of my chicken leg lol well its roughly half the size of the other one now!
i do loads of stair step ups and starting to find that pretty easy now ,but cant step down too well, as i feel the knee give way and my leg drops
doesnt hurt which i suppose is a good thing?
i,m 2weeks away from 6months post op, i think by now i should be jogging and being able to weight train pain free,which i cant

Offline vickster

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Re: has my micro-fracture failed?
« Reply #29 on: February 19, 2012, 05:48:31 PM »
All of this stuff sounds like muscles, perhaps go back to basics, forget the sport, aim for building back up and control

Given the importance of sport to you, I would try to get a proper assessment and regimen from a focused private physio - I reckon it'll be worth every penny of the £50
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















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