Pain 8 months post Micro fracture

General questions about exercises, stretching, gaining range of motion, handling pain and swelling.Also braces, mobility aids, sleeping aids, shoes.
Stelfox
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Pain 8 months post Micro fracture

Post by Stelfox »

Hi to everyone on here!

I'm not a specialist so the only thing I can share is my experiences so far.

On 14th of September 2011 I had microfracture surgery on the later femoral condyle at a bend angle of 15 -20 degrees. The damage was 2cm sqaure and my surgeon (David Elliot) used the microfracture 'steadman' technique and made 6 holes. I was told I could have weight bearing straight away.

This is my 3rd operation to my left knee:
2007 - ACL repair using my hamstring
2009 - medial meniscus damaged and removed and 0.5cm micro fracture repair in same area

Someone in this chat mentioned it is a roller-coaster and that is definitely what its been like for me. I had swelling quite significantly until 4months post op and the swelling went down with icing it every day. I cycled after 3 months and started exercising after 4 months With leg curls, balance ball exercises, one leg press and calf raises. Ive been having strength tests and my left leg was weaker by 30% and is now at about 15% weaker than my right knee and i just cant seem to get it stronger.

At this time May 2012 it's been 8months and I still have slight swelling after a day of just walking and would have a dull pain which is more discomforting than pain. If I have my leg bent more than 90 degrees for a long period of time( 20mins) that would be really uncomfortable. I can't really improve my strength by increasing the weight at the gym as this causes a bit of pain in my knee where the repair was taken place.

I hope this info may help people and I'm happy to of found this sight. I wish everyone the best of luck and it's has been hard for me but I hope to see a positive future.

I'm 24 years old and I would apreciate any comments regarding if these symptoms that I am experiencing now is normal and if it has failed or not from some people experiences. And if it has what would be the next step to take.

If you have read this thank you! :)
2006: Left knee ACL graft repair, small medial and lateral meniscus removed.

2009: Left knee 1cm micro fracture (MFX) carried out on lateral femoral condyle and some more lateral meniscus removed.

2011: left knee 2cm micro fracture (MFX) carried out on the same area
Maverick
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Re: Pain 8 months post Micro fracture

Post by Maverick »

Hi Setlfox, here is my story . . . very very similar to yours :)

I am a 48 year old very active female, former MMA black belt, rock climber, cyclist, etc. I am accustomed to working out 8-10 hours a week. Last September 2012 I had a Lateral femoral condyle (LFC) microfracture (grade 4) in my left knee along with a lateral meniscectomy. Surgery included 7-8 microfractures. I am in my 8th month of recovery and it is going very slow. I spent 2.5 months non-weight bearing and did not get off crutched completely until 5 months. Waiting this long ended up with significant atrophy in my leg. I have an unloading brace that I just recently set to no-loading (0 setting) but still wear when my knee starts getting painful. I am diligent about my strengthening and I work out at the gym 3-4 days a week with 30 minutes cycling (90 cadence) and using weight machines for leg press, leg extension, leg curls and abductor exercises using a cable and ankle cuff. I still have significant knee pain in the microfracture area 2-4 days a week, mostly at night. My surgeon did a bone scan and MRI at 5 months to determine if there were any issues with the knee. Nothing showed up other than thinning cartilage in the original injury area. Although my recovery is slower than I would like, I am better than I was pre-surgery.

I am told that I can no longer run or do martial arts. I am okay with this but I need to be able to go for hikes, cycle, climb etc, which I cannot do know due to the chronic pain.
The chronic pain is getting me down and I have scheduled a follow-up with my OS for June 20th.
1976 Arthoscopy, damaged cartilage
2007 Lateral release of the patella
2011 Meniscectomy and microfracture (grade 4)
2012 Debridement / Chondroplasty
2013 CRPS left knee

Thank you, Maverick
Stelfox
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Re: Pain 8 months post Micro fracture

Post by Stelfox »

Hey thanks for a reply!!!!

I'm sorry to hear your still in pain, and I hope it gets better for you!

I think my damage was 2cm square and I think that's a grade 3 which I think is smaller than yours so it makes sense that your recovery is a bit slower than mine at the moment.

My injury came from wake boarding and was from repeated impact from landing on the water. How did you get your injury?

I went to see my surgeon on Friday and says it's not normal to have this dull ache of mine, so I have an MRI booked for the 31st of May. He said if he can't see anything wrong that we should wait another 6months cause it might still be healing. If I still have it he will send me to a specialist in London that deals with ACI surgery.

Did your surgeon tell you when the pain might go, even though I know it's hard to tell? And has your surgeon mentioned ACI for you? Do you know what angle your knee is at where the damage area contacts your tibia, cause my damage area was on the non weight bearing area, but I'm scared that because I was allowed to walk straight away that I might of damaged the repair tissue?

Sorry for all the questions ......... :P and if your interested I'll keep you updated with my MRI scan and what I'm suppose to do next.

Thank you for replying and hope to hear some good news from your knee situation!
2006: Left knee ACL graft repair, small medial and lateral meniscus removed.

2009: Left knee 1cm micro fracture (MFX) carried out on lateral femoral condyle and some more lateral meniscus removed.

2011: left knee 2cm micro fracture (MFX) carried out on the same area
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Re: Pain 8 months post Micro fracture

Post by Maverick »

Let me see if I get all your questions.

I really think my original injury, although too small to address, was in the late '70s from track. More recently I really injured it with martial arts. My MFX was in my left femur in the back. As my OS said, a very difficult location to do a MFX. My meniscectomy was lateral side on my tibia.

We have not discussed an ACI but I will let you know what he says when I see him on June 20th.

My discussions with both my PT and OS indicated that my pain is not ordinary at this point but my PT is trying to be very positive with me. I have not seen my OS since February.

Please let me know how your MRI goes and your discussions regarding ACI.

Good luck!
1976 Arthoscopy, damaged cartilage
2007 Lateral release of the patella
2011 Meniscectomy and microfracture (grade 4)
2012 Debridement / Chondroplasty
2013 CRPS left knee

Thank you, Maverick
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Re: Pain 8 months post Micro fracture

Post by Maverick »

Stelfox, I have a question for you. Can you describe the pain that you are having? My pain is really in two separate places. The first seems to encompass my whole knee like there is a vice grip around it and it is being attacked by a bunch of bees. The second is directly in the microfracture area. The pain is not surgical or tissue. It is more of a pinching / stabbing pain. The best way to describe it is like getting an injection in the area, similar to a cortisone shot. There is a sensation of pressure, pinching, and moderate to intense focused pain. It is not usually 24x7 and is typically worse in the afternoon / evenings, presumably because I have been on it for a while. It can be 24x7 some days which does become somewhat of a challenge and this is usually when I get the TENS unit out or grab the pain meds.

Thanks!
1976 Arthoscopy, damaged cartilage
2007 Lateral release of the patella
2011 Meniscectomy and microfracture (grade 4)
2012 Debridement / Chondroplasty
2013 CRPS left knee

Thank you, Maverick
Stelfox
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Re: Pain 8 months post Micro fracture

Post by Stelfox »

My knee doesn't feel quit as intense as such but it would feel ok in the mornings but I can still feel discomfort. No sharpe pain but after half a day on my knee it will feel stiff and towards the end of the day my knee would have a bit of swelling, and i ice it most days for painrelief and to try a get rid of the swelling. I wouldn't have pain if I bent my leg but if I kept it bent for a while it would start to get painful. I obviously don't run or wakeboard anymore but if I know if I did run my knee would have allot of swelling.

I'm just wondering how big is your grade 4 damage?

Thanks

I
2006: Left knee ACL graft repair, small medial and lateral meniscus removed.

2009: Left knee 1cm micro fracture (MFX) carried out on lateral femoral condyle and some more lateral meniscus removed.

2011: left knee 2cm micro fracture (MFX) carried out on the same area
Maverick
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Re: Pain 8 months post Micro fracture

Post by Maverick »

My damaged area was about 1.5 cm and took 7-8 microfractures.

I do have some of the same pain symptoms as you do. Typically, although not always, my knee is pretty good in the morning. Around noon, the pain picks up and I to have swelling. This is when I usually put my brace on. Ice is a big help.

Good luck with your MRI this week!
1976 Arthoscopy, damaged cartilage
2007 Lateral release of the patella
2011 Meniscectomy and microfracture (grade 4)
2012 Debridement / Chondroplasty
2013 CRPS left knee

Thank you, Maverick
Stelfox
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Re: Pain 8 months post Micro fracture

Post by Stelfox »

Hi maverick

I had the results from my last MRI and The mfx hasn't fully worked, and I've got osteophytes starting to grow(basically osteoarthritis) but the osteophytes isn't causing me the discomfort it's the failed mfx.

My os said if I was in my 40s he would just tell me to live with it but because I'm 24 and love my sports he has sent me to another specialist in London

My os said he is not a great believer in all the new procedures which has put doubt in my mind to go ahead with another surgery.

I kind of think that I'm still lucky to walk and cycle and just have to accept that I won't be able to do any intense sports, so I'm going to speak to this other specialist to weigh up my options to see if it is worth having another surgery which may improve my knee or just leave me the same.

So I'll post my results after I've seen him

Thanks :)
2006: Left knee ACL graft repair, small medial and lateral meniscus removed.

2009: Left knee 1cm micro fracture (MFX) carried out on lateral femoral condyle and some more lateral meniscus removed.

2011: left knee 2cm micro fracture (MFX) carried out on the same area
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Re: Pain 8 months post Micro fracture

Post by vickster »

I don't really get why your OS wouldn't operate if you were 40? ??? Maybe 50+? He sounds very conservative and not into cartilage repair. I am 40 next month and my surgeon would be more than happy to try to repair my defect - it is me who is resisting ultimately

Definitely see a surgeon who is a specialist in repairing cartilage - to where/whom is your OS referring you to? Stanmore?
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
PonyExpress
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Re: Pain 8 months post Micro fracture

Post by PonyExpress »

Hi, not impressed that your OS would tell someone in their 40's that they would just have to live with it. I'm 48 and if my MFX doesn't work I don't intend to just give up and accept I can't do what I want - 40 is not old!!!

I'm guessing it was just a turn of phrase that he was using ;)

However, at 24 I definitely would not just be accepting that walking and cycling were my limitations. I hope all goes well with the specialist in London.

Wishing you well, x

ps - Vickster Nooooo! 50 is also not that old, lol, wait 'til you get there! :o
19th Feb 2012 Damaged knee falling off horse, banged leg on jump
18th Apr 2012 MRI indicated significant bone bruising
30th Apr 2012 EUA arthroscopy, MUA, MFX medial femoral condyle
17th Jul 2012 Cortisone injection into Fat Pad
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vickster
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Re: Pain 8 months post Micro fracture

Post by vickster »

50 isn't old in general terms but unfortunately the chances of success of repair are rather slimmer as you get to that age. There must be some folks on this board who have had a repair but not that many. I'd be surprised on the NHS for sure - not sure if the OP has private cover (that said, the private companies are pretty unwilling to pay too as I have found out in the past)
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
PonyExpress
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Re: Pain 8 months post Micro fracture

Post by PonyExpress »

I went private as NHS was going to take too long, the company has paid up - no queries.
19th Feb 2012 Damaged knee falling off horse, banged leg on jump
18th Apr 2012 MRI indicated significant bone bruising
30th Apr 2012 EUA arthroscopy, MUA, MFX medial femoral condyle
17th Jul 2012 Cortisone injection into Fat Pad
Maverick
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Re: Pain 8 months post Micro fracture

Post by Maverick »

Pon yExpress, sorry to hear of your MRI results. I am glad to hear that you are going to see a specialists though. There are many alternatives for you to look into so don't give up yet. I agree with Vickster that you should do some more research on this site to see what others have done.

I see my PT again a week from Monday and my OS the Wednesday after that. My PT says that I have patella femoral syndrome due to my atrophy so I am working on strengthening my VMO now in hopes that it helps with the pain. The jury is out so far. I am interested in your continued progresses as our situation is so similar except, our age. I did have a MRI at 5 months post op that did not show anything definitive. I will let you know how my appointment goes.

Good luck!
1976 Arthoscopy, damaged cartilage
2007 Lateral release of the patella
2011 Meniscectomy and microfracture (grade 4)
2012 Debridement / Chondroplasty
2013 CRPS left knee

Thank you, Maverick
PonyExpress
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Re: Pain 8 months post Micro fracture

Post by PonyExpress »

Maverick, it was Stelfox not me that had the poor MRI results. I'm still hopeful for a good outcome, fingers crossed.
19th Feb 2012 Damaged knee falling off horse, banged leg on jump
18th Apr 2012 MRI indicated significant bone bruising
30th Apr 2012 EUA arthroscopy, MUA, MFX medial femoral condyle
17th Jul 2012 Cortisone injection into Fat Pad
Maverick
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Re: Pain 8 months post Micro fracture

Post by Maverick »

Stelfox, my apologies. That will teach me to view these posts on my iPad :)

Pony Express, can you remind me how far along you are on your MFX?

Thanks!
1976 Arthoscopy, damaged cartilage
2007 Lateral release of the patella
2011 Meniscectomy and microfracture (grade 4)
2012 Debridement / Chondroplasty
2013 CRPS left knee

Thank you, Maverick
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