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Author Topic: Post-Op: Microfracture/Chondroplasty  (Read 23754 times)

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Offline agilk9

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Post-Op: Microfracture/Chondroplasty
« on: February 17, 2004, 10:20:19 PM »
I had arthroscopic surgery on my right knee on 12-5-03. What was thought to be a "standard" meniscal tear repair turned into debridement, chondroplasty and microfracture of the medial tibial condyle. Apparently, the pain I had been having was due to articular cartilage damage.

12-5 It was a surprise to wake up and be in a CPM machine that was moving the knee from 0-70 degrees, when I thought I'd be walking out of there... a little depressing, but I thought it was the pain meds.

First week - just keeping the pain under control, and getting used to crutches, since I was to be no weight bearing for 6 weeks. The enormity of the surgery and the changes it was going to mean in my life were depressing.  I was unprepared for hearing things such as "you'll have to give up waterskiing, definitely this year, maybe forever", "no running with planting and pivoting of your leg, this year, maybe forever"  My true joy in life is training dogs in agility where I compete at a fairly serious level.  Combine the pain meds, the laying on the couch and the news, it was a difficult week, only made better by good friends and wonderful husband. Stayed on CPM machine entire week for as many hours as I could reasonable handle.

Week two - saw the OS first thing, everything looked good, swelling was fairly minimal, he was pleased. Told me to start Physical Therapy, sent the order for the therapist Wanted me to continue CPM for another week. No weight bearing.   PT guy showed me quad sets, ROM exercises and said little could be done for muscles as long as I was No weight bearing. This proved to be disastrous.

Week 3-6 -- Gradually weaned from pain meds, with some discomfort, and maybe half a hydrocodone for nights. Continued quad sets, and ROM exercises. Went to PT where the guy did zippo, zilch.  I asked about EStim and he said that stuff doesn't work,  I questioned it since OS wanted to use it. He said he'd called OS and everything was ok. It was getting harder to move my leg in/out of bed/couch. You could see the quads turning to mush.

Week 6+  OS visit....he was pissed, the PT guy didn't follow orders. My patella, due to lack of VMO strength is not tracking properly. I had NO strength whatsoever in quads.  I changed PTs (obviously) and started working with a gal who had similar surgery (OATS) and put me right to work. Got the ok to slowly increase weightbearing

Week7-10  Worked hard on strength training,  weight bearing is slow due to pain in both patella and what appears to be the VMO.  The IT band gets knotted up too.  But, I was gaining strength, saw some muscle definition using Russian Estim and lots of leg raises and stationary bike stuff.  Hamstring curls were good, but quad knee lifts were impossible. Worked hard these weeks to just get my leg straight while in a seated position.

Week 10+ Saw the OS again, he's much happier now that I'm getting around. Went from two crutches to one, to now just a cane.  Full weight bearing is still very painful, and walking from sink to fridge (very important  :D ) is about it.  My patella is still off and now I'm wondering whether I have scar tissue issues.  I'm swimming/water walking, take no heavy pain meds and am continuing to work on strength and movement.

If you've read this far, thanks.  I wrote this because I know there are other people out there who'se microfracture surgery is not healing as fast as either OS or PT folks would like you to believe.  I get scared to death that maybe I'll never be able to walk normally again, but that is followed by trying to keep up the spirits so I don't sink into a well of dispair.  I'd invite anyone who has had microfracture etc to let me know how they are doing.

Aggie

Offline stgiles16

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Re: Post-Op: Microfracture/Chondroplasty
« Reply #1 on: February 17, 2004, 11:01:43 PM »
Boy was I happy to see your post. I posted something similar last week with almost no response. I was beginning to think that I was the only one around who had this surgery!!!! I started out with the same diagnosis (men. tear) WRONG! Came out with chondroplasty and microfractures just like you , but wait it gets better. Microfractures didnt work ! Second surgery same as the first but add plica removal, bone spur removal, debridement of pre arthritic deterioration. This is not a fun thing. You lifted my spirits just by acknowledging that the recovery for this thing is awful! :) I am 7 wks postop and weight bearing some now. Not going to PT yet and my thigh muscle is mush  also. Quad sets do not work. I have a very hard time lifting my leg straight from a sitting position. I also have very strong pain when doing any leg lifts at all. Does it hurt you to do leg lifts? i would love to compare notes with you but dont know how to leave an address on here that not everyone on earth will get (there are nuts everywhere so dont get offended anyone).I can walk a little now, pretty much what you said, fridge to sink lol. I can use one crutch but the cane is not working for me. I also fully understand the depression.  I have really battled it after this last surgery. We will get well, just keep positive and work hard.
Missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

Offline agilk9

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Re: Post-Op: Microfracture/Chondroplasty
« Reply #2 on: February 17, 2004, 11:18:05 PM »
Hi Missy,

Run, don't walk (I know, bad joke  :-/ ) to your OS (maybe just call him/her) and see if you can get started on PT.  Those quads are so darn important to the wellbeing of your knee that I firmly believe part of my rehab slowness is the fact that I didn't do anything those first six weeks.  I also know that not all PT or OS believe in electrical stimulation, but doing the russian Estim really helps when quads are total mush!

WHen you go to PT don't be afraid to shop around.  Find someone who will listen, who will not pawn you off on some hired help and who will look at a total plan for your strength....not just your knee!

Doing straight leg lifts doesn't hurt me anymore. I can put on about 5 pounds of ankle weight and do them.  However, if I bend my knee over a towel, or ball, and then lift my lower leg til straight, THAT hurts because of my patella.  PT keeps telling me it's the quad muscle that runs on the inside from knee cap to thigh (VMO) that is the first to turn to mush, the last to come back.  It's a hard one to isolate and work on.

Keep talking, we'll work our way through this yet!!!

Aggie

Offline stgiles16

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Re: Post-Op: Microfracture/Chondroplasty
« Reply #3 on: February 18, 2004, 12:28:38 AM »
I did a ton of exercises for my VMO before this last surgery. They thought that fixing it might let me escape surgery. It was mush from the last operation. OS says walking will help build up my thigh muscles. Pt suggested Electronic Stim. but havent gotten it yet. I am waiting on an e-mail from him about it. OS is 275 miles away from home so alot is done by phone and e-mail. Did you get the message I sent you? I dont know how it works but I tried.
I will e-mail PT again tomorrow and check on that machine.
Thanks
Keep me posted
Missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

Offline Marie

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Re: Post-Op: Microfracture/Chondroplasty
« Reply #4 on: February 18, 2004, 05:52:50 AM »
Hi there,

Wow... I didn't realize that recovering from microfracture would be such a big deal..... I feel kinda silly now.  I had 5 procedures done on my knee in September - the main one was the TTO, but I also got some stuff that I hadn't bargained for, like the microfracture!  

That may explain part of the pain that I was in post-op and some of the difficulties I've had in recovering (regaining ROM & getting VMO strength back).  I'm still having problems distinguishing between my recovery & each different procedure that I had done, but this is certainly something new I hadn't really considered before.  Thanks for the postings.

Aggie, I'm writing to let you know that it is definitely possible to walk again like you never had a problem in the first place.  I started walking normally about 4 months post-op, which was later than expected, but is definitely better than never.  My IT band & VMO get very tight, so my PT massages them before working on me (we're still working ROM).

Missy - walking will help A LOT, even if it's cane or crutch assisted walking.  Just so long as it doesn't kill you to weight bear, just do it!  And then ice & elevate as needed.  My saving grace was a crazy conference at 6 weeks post-op where I was walking (with my crutches) 5-10 miles a day!  Was I ever glad to see the ice machine at our hotel at the end of our day!!!   I must've been doing e-stim/Russian for nearly 3 months before I could do a straight leg raise (SLR) on my own, and even then it took all the strength I had in me being redirected to that  darn VMO!!!  The VMO has only stopped hurting within the last couple weeks & I so I've just recently started weights with the SLRs.  It definitely helps to point your toes out laterally when doing the SLRs.  If you can lock your good knee & do a SLR, try & do the same thing with the bad knee.  Also, take the advice about finding a PT who can really help you... I found someone excellent & it's made a world of difference.

Take care all!
Marie
« Last Edit: February 18, 2004, 05:55:55 AM by Marie »
24y/o - had subluxing right patella, frequent dislocations, osteoarthritis.
Sept26/03 - TTO, scope, LR, medial plication & microfracture (right).  
Slow ROM recovery (126).
My new PT is awesome!!!

Offline agilk9

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Re: Post-Op: Microfracture/Chondroplasty
« Reply #5 on: February 18, 2004, 06:32:50 PM »
THanks for posting, Marie.  It's hearing about length of time for recuperation that is lifting my spirits!  It seems my full weight bearing/walking is going awfully slow.  The knee just doesn't feel stable when I walk unassisted.  There's always the fear of this being something more, something worse, something not healing, etc etc.  It's nice to hear that it may just take time, time, time!  ARGHHHH!


5-10 miles a day on crutches at 6 weeks, wow!  :o  :o  :o   I think that would have put me crying in a corner!  Five procedures, that's a lot.  What all did you have done, Marie?  When you say you started walking normally at 4 months, did you use a cane prior to that? Gimped around without one?  How'd you feel at about 3 months or so?

What I've decided to do is to start walking more (hard to do here in icy weather) but Walmart is as good a place as any.  Instead of pushing the weightbearing issue, I'll gently use my cane til some of those muscles are built up again.  Funny thing is, I can do straight leg raises with 5 pounds of weight til the cows come home.... hamstring curls, no problem.... I just feel lots of pain in the VMO/patella area.  The actual microfracture site aches so now and then, but it's really not that bad unless i do a quick accidental sidestep and then it lets me know it's not fully healed yet.

My OS told me that it takes 6-9 months before the fibrocartilage is completely "organized".  Right now, according to him, there's a layer of cartilage but the fiber bonds are not well aligned. As time and pressure/effort are applied, these bonds align themselves into the best possible matrix for a functioning cartilage.  This is what takes time.  

Oh well, Onward, Ever Forward -

Aggie (who's off to go stationary bicycling...trip around the world. yeehaw!) ;D


Offline stgiles16

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Re: Post-Op: Microfracture/Chondroplasty
« Reply #6 on: February 20, 2004, 03:57:04 PM »
Hi guys, my weight bearing is going pretty well. I can walk around the house for a good 10 minutes now before i have to grab a crutch. But I still cannot do the dreaded SLR. When I try to do those, I get terrible pain under my knee cap. My VMO doesnt hurt but it may be causing this part of my knee to hurt. The only time that particular section hurts is when I try to do the SLR.  I got in touch with my OS about a stimulator but havent heard back from him yet, I am giving him until Monday and then I will call again. It makes me feel better knowing that my recovery is not unusually slow. Thanks for posting guys.
Lots of LUck
Missy ::)  ;D
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

Offline Marie

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Re: Post-Op: Microfracture/Chondroplasty
« Reply #7 on: February 21, 2004, 03:05:55 AM »
Hi Aggie,

It's DEFINITELY too cold & icy here in Canada for a safe walk outside..... my real walking at 6 weeks post-op was done in New Orleans at a conference in November.  The conference center was probably 1/2 mile from one end to the other, maybe more, and I wanted to see soooooo much while I was there (at the conference & in the city... I got catcalled "crutches" on Bourbon St  :-[, but I'm glad I experienced it), so that helped A TONNE (the walking, not the catcalling).

I tried to ditch the crutches after that trip (7 weeks post-op) since I built up so much quad strength during that week.  Then I walked with a cane probably until 10-11 weeks post-op.  At 3 months, it was Christmas.  I was feeling pretty discouraged, but since I had time off I spent most of it rehabilitating & consequently I saw much improvement in January.  I was BRUTALLY slow and walking with a limp until 4 months post-op.  Now it's no hassles & I can walk on uneven ground, snow & ice w/o even worrying about falling.

Walmart is definitely just as great a place as any to go for a walk.   :D   Just don't let the Walmart greeter get you a wheelchair!  (haha... by the way, I actually bought my cane at Walmart... they had quite a selection!!!).

Glad you can do the SLRs & the biking... my OS is big on both for getting strength back!  

If I can give you any advice, just be patient, learn to appreciate things that you may have missed before your knee began to slow you down, make your recovery a priority, and try to stay positive.  You can do it!!!

Hugs-
Marie

P.S.  The operations I had included arthroscope, tibial tubercle osteotomy, lateral release, medial plication & microfracture.
« Last Edit: February 21, 2004, 03:07:01 AM by Marie »
24y/o - had subluxing right patella, frequent dislocations, osteoarthritis.
Sept26/03 - TTO, scope, LR, medial plication & microfracture (right).  
Slow ROM recovery (126).
My new PT is awesome!!!

Offline agilk9

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Re: Post-Op: Microfracture/Chondroplasty
« Reply #8 on: February 21, 2004, 10:27:31 PM »
Thanks Marie.....it's wonderful to hear about other people's recoveries.  Intellectually I know that everyone is different,  but the emotional side of recovery/rehab is always loaded with "what ifs"....like "what if it didn't work?" "what if I'm different and I'll always be like this".  Therefore, it's great to hear real experiences.  I'm sure your long walking experiences at 6 weeks helped your quad strength tremendously. But then it still took a while for you to get rid of the cane, which is encouraging to me since I went from two crutches to one crutch to a cane in a matter of less than a week, so naturally, I thought I could ditch the cane after a week or so.  That's not happening yet.  Although I am noticing longer periods of walking around the house without it.  I've also been told to back off of some of my work at home, I was doing too many, and too much exercising....I think that's helping my muscles/tendons to calm down a bit too.

Thanks again for your  sharing your rehab/recovery, it means a lot...

Aggie

Offline agilk9

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Re: Post-Op: Microfracture/Chondroplasty
« Reply #9 on: February 24, 2004, 06:48:26 PM »
Thought I'd post an update -

Week 12 -

After spending a week "taking it easier" on the knee to let strained muscles calm down a bit, I'm back at hitting the PT pretty good.  Continuing to walk with a cane, although at times I don't really use it.  Any inactivity seems to lead to tightness in the knee, so when it feels tight, I just get on the stationary bike (low tension) for 5-10 minutes to loosen things up.

Even though the physical aspect of this rehab are pretty big, the mental aspects are huge.  It's the fear of something being wrong that drives my day, and it's bound to go up and down several times in that day. Seems like everyone tells me that "this just takes time", at which point I want to scream at them, "but you don't know how bad this feels".  

Oh well, onward ever forward, I guess.  There's no doubt my knee is stronger than two weeks ago, no doubt that there are small changes occuring, it's just not fast enough for me! ;)

I do think that a lot of OS's do us a disfavor by not being more up front about the rehab after some of these procedures.  The impression I got was that I was to be non weightbearing for 6 weeks after surgery, after which "I was on my own"....which I interpreted to be fully capable of getting around and being done....oh foolish me....  I do think my fears would be somewhat allayed if I had been told that it takes months and months to get back to having a fully working knee.  But, I guess, that's hindsight now....

Happy Healing all -

Aggie

Offline stgiles16

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Re: Post-Op: Microfracture/Chondroplasty
« Reply #10 on: February 24, 2004, 07:06:37 PM »
Aggie, you worded my feeling perfectly. Keep plugging along girl, we will survive this (i hope) lol :D
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

Offline Marie

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Re: Post-Op: Microfracture/Chondroplasty
« Reply #11 on: February 25, 2004, 02:17:25 AM »
Hi Aggie,

Glad you're seeing a little glimmer of light at the end of your tunnel.  

I had ample warnings about recovery periods before my surgery, but somehow still expected that since I'm young & athletic and had an aggressive approach to rehab that I'd recover even more quickly than expected.  Unfortunately, my body had other ideas.  

You seemed to say it right about the mental aspects.  I've grown a lot as a person these past few months, and nothing (not even the best OS in the world) could have prepared me for that challenge.

Cheers to everyone fighting battles of the mind (not just of the knees).  May you all be victorious!  ;D
Marie
24y/o - had subluxing right patella, frequent dislocations, osteoarthritis.
Sept26/03 - TTO, scope, LR, medial plication & microfracture (right).  
Slow ROM recovery (126).
My new PT is awesome!!!

Offline agilk9

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Re: Post-Op: Microfracture/Chondroplasty
« Reply #12 on: February 27, 2004, 03:00:30 AM »
Hi Marie -

You've been a bright light here, thank you. Wanted to share that, although I'm even scared to say it lest I jinx it, I think things are improving. (sitting here with fingers, toes, eyes crossed just in case :D )  I'm thinking that the light at the end of the tunnel may not be an oncoming train!
PT is going fairly well, I'm doing some very short times on an elliptical trainer, and longer times on the stationary bike.  We tried the stairstepper, and although I can do it, the PT said no, my gait was too lopsided for her liking.
At home I'm walking mostly without the cane now, and in places outside where the ground is even and predictiable I can also walk without a cane.  It's very slow going, but that's ok.
The area of my surgery (femoral condyle) doesn't seem to be putting up a fuzz, it's the kneecap and associated ligaments and VMO muscle.  That's where the tightness is and that's where the work needs to happen.
My PT also has pointed out that while I can do nice short squats, my good leg appears to be taking 90 percent of the weight, and she wants me to concentrate on putting more weight on the "operated" (I'm not going to call it my BAD) leg. So, I have some things to work on.

Just thought I'd share what is hopefully a brighter update. I have a long way to go, and I'm doing it slower than most, but so every now and then I get a glimpse of progress.

Aggie

Offline stgiles16

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Re: Post-Op: Microfracture/Chondroplasty
« Reply #13 on: February 27, 2004, 05:16:40 AM »
HI Aggie, Hi Marie, I got an update from my OS today too. Things seem to be improving here also Aggie. I have been walking mostly with no assistance.  Os said today that he will order the e stim ( i have no clue how to spell that thing) for me to use to help my quads and vmo. He also said that the reason my knee hurts so bad during slr is because of scar tissue and to massage it. I know, I know, yall told me to do that already lol.  He is gonna call me in a month for another check up and the machine thingy will be shipped to me to work out at home. NO PT YET LOL LOL LOL ;D ;D ;D ;D

Great news about your progress Aggie. I am soooo happy for you. Keep up the hard work girl and you will be well in no time
Missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

Offline Marie

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Re: Post-Op: Microfracture/Chondroplasty
« Reply #14 on: February 27, 2004, 05:49:58 AM »
Yay Progress!

Awww... thanks Aggie... you're sweet!  And great news about the unassisted walking!

Missy - glad you're getting the e-stim/Russian!  It made a huge difference for me in getting that VMO firing.   I think for me the SLRs hurt b/c of scar tissue, but also b/c I had a medial plication & my VMO hadn't been all that active before surgery (in fact, I couldn't do a SLR before), so it got stressed everytime I tried to make it fire & do actual work.  

Good luck to both of you!
Marie

P.S.  Measured my ROM at 111 today!  
24y/o - had subluxing right patella, frequent dislocations, osteoarthritis.
Sept26/03 - TTO, scope, LR, medial plication & microfracture (right).  
Slow ROM recovery (126).
My new PT is awesome!!!