In summary, microfracture and the rehabilitation following this surgical procedure remain relatively new. I have not worked a day since surgery. Yen Y, Cascio B, O’Brien L, et al. Why is this? I returned to practicing BJJ around 5 months afterward focusing on getting back into shape and not rolling hard. Thursday, February 23, 2012. When the microfracture is on the top of the shin bone (tibia) or the end of the thigh bone (femur), weight is limited by having a patient use crutches. Thanks in advance! A microfracture awl perforates the subchondral bone to a depth of approximately 2 mm to 3 mm to induce bleeding. My knee needs movement or stiffness occurs. This is the healing response that is seen in microfracture surgery. Surgery requires “open knee” meaning cut the patella-femoral tendon. — Jordana Bieze Foster, Editor. My OS said that the microfracture operation would give me 10 more years of activity before the replacement. Your email address will not be published. Implementing one standardized rehabilitation protocol following autologous chondrocyte implantation or microfracture in the knee results in comparable physical therapy management. to surgery, presence of arthritis, previous surgery and post-operative rehabilitation program.2-4 Because of this, there are some patients that may not be candidates for the microfracture procedure. I felt pretty good for awhile, but the pain has increased, soar and stiff much of the time. Treatment of articular cartilage defects in athletes: an analysis of functional outcome and lesion appearance. Going Home After Surgery. For that reason, it is critical to follow your surgeon's instructions when recovering from microfracture surgery. Conversely, the rehabilitation specialist can alter any of these factors as a means to unload the joint surfaces if the patient does demonstrate a joint effusion or other negative responses. Am J Sports Med 2009;37(1):33-41. Months further still have lack of motion and pain . Stationary biking without resistance and a deep-water exercise program begin 1 to 2 weeks after surgery. The surgery is quick (typically lasting between 30–90 minutes), minimally invasive, and can have a significantly shorter recovery time than an arthroplasty (knee replacement). It’s very similar to the pre-surgery pain. I still have aches and cracking after a workout, but it is tolerable. Injuries to the articular cartilage of the knee are serious, with potentially debilitating consequences if not managed appropriately. This article recommends 20 to 30 percent weightbearing for eight weeks. Had microfracture surgery two weeks ago. Needless to say I was crushed, and the following weeks yielded a bad attitude and tons of apprehension. I am a 55 yr old female, not overweight, but not in the best physical shape before surgery. This site uses Akismet to reduce spam. Lower Extremity Review or LER Magazine fills the lower extremity injury information gap for lower extremity practitioners in the fields of lower limb orthotics, lower limb prosthetics, lower limb O&P, podiatry, pedorthic, lower extremity physical therapy, foot and ankle, pediatric, sports medicine, orthopedic and athletic trainer markets interested in prefabricated and custom ankle and knee bracing, ACL, off-the-shelf and custom ligament knee bracing, osteoarthritis knee bracing, insoles, full contact diabetic foot inserts, orthotic materials, multi-density inserts, dual density insoles, custom foot orthotics, night splints, standard and hinged AFOs, diabetic footwear, diabetic socks, pressure measurement, sports medicine, neuromuscular disorders, stroke, drop foot, PTTD, flat foot, rehabilitation and biomechanics. Straighten the knee you have had surgery on by tightening the thigh muscles. Everything I have read, says that you are not supposed to bear weight for 6 weeks! The brace & crutches are gone, the cane is in the trunk of the car and the limp and ability to climb stairs ebbs and flows not only day by day but also from morning to night. Now I can walk SLOWLY down a 20cm high stair, but after a few times, it “locks” up again. Microfracture is a simple but cost effective method to treat smaller cartilage injuries. The pain is getting a little bit less but not to where I thought (and was told) I would be after two weeks. Normally when tissues within the body are injured, it is the blood supply that delivers the critical nutrients to heal that injury. I was just checking up a few things, as I am an Accredited Exercise physiologist in Australia, and have a lady im assisting post arthroscopic cartilage repair in her knee. If I put too much weight on my leg, I do get some shooting pains. Various authors cite ranges of non-weightbearing from one week to three months after microfracture surgery to the talus. The athletes are not allowed to put any weight on the injured leg for 6 to 12 weeks. Recovery After Ankle Microfracture Surgery (Talus) Dec 18, 2013. My surgeon suggests never running. Knee microfracture surgery is a common method used for cartilage repair. I was given some pain meds, and they help a little bit but I cannot get comfortable to fall asleep. I see my OS next week for my 6 week post op and he will hear an earful. In the last 20 years orthopedic surgery has made many advances. It’s been tough to say the least and at 5-1/2 weeks was permitted to ditch the crutches. 9 Things to Consider Before Hip Replacement Surgery, Patellofemoral Knee Replacement Is Just for the Kneecap, Kneecap (Patella) Injuries: Types, Causes, Treatment, How to Know If Your Knee Pain Might Be Osteochondritis Dissecans, Explore What Talus Fractures Are and Why They Occur. Blevins FT, Steadman JR, Rodrigo JJ, Silliman J. Slow and steady. I have now been told not to weight bare for 4-6 weeks and will be on light duities for upto 4 months with ongoing assessments.. At that visit, the patient is also counseled on the process to gradually wean themselves off the crutches. Mo more pain in ankle almost immediately after finishing the series. Dr. Richard Steadman, who pioneered the surgery, found that 76% of the NFL players in whom he performed microfracture returned to play the following season. The P.T. Any thoughts? Articular cartilage gets its nutrition from the surrounding fluid of the joint. I hope that I can return to normal life at some point. i am amazed to read so many micro fracture related blogs… Rehabilitation following microfracture for chondral injury in the knee. Orders for crutches for 48 hrs. I’m in no hurry to get 100%. I am 47 and it truly is one of those things I really still enjoy and at a pretty competitive level. Finally, the rehabilitation specialist needs to be vigilant about examining for joint effusions as progressive joint loading forces are applied, since effusions are an important marker of excessive joint stress. Numerous studies have also been performed to compare microfracture surgery to other treatment options for cartilage damage. I am very concerned about how I’ll respond to putting weight on it in a couple of weeks. Footwear Design & Smart Data, What’s Ahead? Is ACI the Right Way to Repair Your Knee Cartilage? It is now 5 weeks and I’m pretty sure the damage is done for any chance of proper healing. Thank you! to ask her about this and she re- assured me it’s absolutely fine that I was on crutches only one day. The problem of chondromalacia patellae. It does not have a blood supply that brings nutrients to the cartilage cells. Sharp pain when I walked, climbed stairs, just general things. By the end of week six, there should not be enough room to slide your hand easily between the back of your knee and the bed. Sounds like a lot of self control to not get on it too soon and beat up the blood clot that is making cartilage grow. I have to limit myself in conditioning a lot and I am not up to the level of play I was at before. I will never go to another group! I was given some pain meds, and they help a little bit but I cannot get comfortable to fall asleep. Short term results looked promising, though the results often deteriorated over time. I had arthro for a torn meniscus, and while in there, my doc found floating cartliage requring microfracture. Why he did microfracture I do not know. I haven’t had pain since 8 days post operation. If it doesn’t he is going to send me to a cartilage specialist. Nho SJ, Pensak MJ, Seigerman DA, Cole BJ. 1 of 3 Texans linebacker Jadeveon Clowney  is believed to be a good candidate for the microfracture surgery. Because the success of this procedure relies on the formation of a blood clot at the site of the defect, protection of the clot is paramount during this early time frame. Anyone experience loose feeling knee afterewards … actually both of my knees feel weird. Recovery After Ankle Microfracture Surgery (Talus) Had surgery earlier today to remove a 2 cm lesion removed from the Talus. Arthroscopy 2003; 19(5):477-484. I asked where my arthritis was and we could see where by looking at the M.R.I. So for all you guys I am now feeling positive and have hope but I know I will never be the same and wonder what my future holds but you certainly appreciate things a lot more when you’ve been through the longest and hardest rehab ever. Im 36 and very active–and my recovery is going wonderful! Makes sense. I play (used to play that is now) squash regularly, run, cycle and go for the occasional Gym session and swim. The clinician has at his or her disposal the progression from bilateral to unilateral, progressive range of motion (progressive depth), and the addition of external weight as a means to progressively challenge the patient and load the joint surfaces. Return to sports participation after articular cartilage repair in the knee: scientific evidence. If you do not let the blood clot do it’s thing and regrow cartilage, the contact will be directly on the bone. The fluid just keeps coming back.. any sugestions or advice. Iam dealing with a company docter who I liked but seems to be done with me. I was supposed to walk out of the office but instead on crutches for two weeks. Photo: Rick Osentoski, FRE Microfracture surgery isn't for everyone. In order for microfracture surgery to be effective, the rehabilitation that follows must be performed as instructed. Which is it? One may balance in the shower. So from what I’ve heard- both from my doc and various literature on the web- micro fracture has a poor outlook in older patients with trochlear tears. And he is a top surgeon, most trusted, etc in his field. Prins J, Cutner D. Aquatic therapy in the rehabilitation of athletic injuries. He is the director of adult spinal deformity & complex spinal reconstruction at Massachusetts General Hospital and is on the faculty at Harvard Medical School. Day 1. The athlete must develop adequate strength and neuromuscular control to contend with joint stresses. I feel for you Mike. Also even doing yard work with heavy equipment! Steve, I just wanted to comment and say my OS said I could bear weight immediately but only because of the size of my cartilage lesions. This means crutches or walker for this time period and no significant weight on the leg or walking for this time period. 14. Mithoefer K, Hambly K, Della Villa S, et al. those first six weeks of non weight bearing is imperative to the recovery cycle, after that moderation is the key to recovery. CO The focus is on knee elevation, pain relief, ice to control swelling, incision protection, and rest. Appropriate rehabilitation following the microfracture surgery is an essential part of the recovery process. Now, years later, microfracture has shown to be very successful with a relatively short recovery time line. After reading all these comments/stories, I’m at a loss with regard to what I should be doing! Thanks to all who have commented on this article. I can turn and bend my leg on a patient table just fine, but when there is anyweight bearing (stairs) then that is when my leg feels like it is stuck when I try to bend. Learn how your comment data is processed. I feel my surgeon overstepped his boundaries big time since I had a very pointed conversation with him about not having MF. 15 months out of MF and cant walk steps. This has been a very humbling experience for me. i am 6 months out of micro fracture and the results are what my doc and i expected… Now I’m straightening my knee on the couch. I have a large Bakers cyst behind same knee and a tear in ACL but these were not addressed in surgery. 10. A lot of swelling and pain and disability. Before you go to the hospital for surgery, set up your home to make your recovery and life easier when you come back. Articular cartilage: injuries and potential for healing. The technique was frequently used in athletes after they injured their joints. I was on crutches, NO weight bearing for 6 weeks. If not already taking place, participation in team strength training sessions is a safe reintroduction to team activity. Progressive, controlled loading of the repaired joint is the key to safe and effective rehabilitation. 2. I cringed when I read that some of you were advised to load weight on it during your first six weeks. To assess your progress from week to week, lie flat on the bed and attempt to put a hand under your knee. My post op appt the PA i saw gave me a new knee brace w hinges on the sides and said things should get better once i strenghten my knee. When in doubt, ice, take ibuprofen and be passive; as being passive with your activity can’t do damage that inhibits scar tissue formation. There are a lot of great ones out there. No doctor knows exactly what is wrong with my knee, but according to MRI and X-ray, my knee looks pretty good. That is what sent me to the dr for the hundreth time. My knee was extremely swollen but I struggled to get through the exercises. Standing one-third knee bends with a great deal of the weight on the uninjured leg begin the day after surgery. Definitely feeling the burn, even with pain pills and beers. I guess the only advice I really don’t want to hear is to stop playing basketball. Day 3 of work my knee was so swollen could not get 90 degrees. The clinician is reminded that because of the buoyancy effect of the water, the amount of weight bearing progressively decreases as the percentage of the body is submerged.15. This is why I can’t walk down stairs (your leg straightens fully as you begin stepping down). My pelvis is higher on one side than the other. J Orthop Sports Phys Ther 1998;28(4):192-202. Now this is 2010 go back to running after say a month or two then soccer and eventually just randomly it will buckles. The type of cartilage that provides smooth motion at a joint surface is called articular cartilage. In the ankle, post-op (couldn’t walk at all for 3 1/2 months) had much more stability than prior to surgery, but extreme increased pain. Havent even thought about crossfit as of yet, and havent played basketball. I have had ACL reconstruction on both knees, one 19 and one 18 years ago. I’m told 4th hand, that the surgeon found a “massive” meniscus tear and grade 4 arthritis on investigation and decided to perform MFR – which has effectively ended my life for 2 months as I’m told by one of the 4 consultants I’ve seen to date (still not seen the person who performed the surgery) that I have to stay on crutches and be non-weight bearing for two months! But… then I see on here where the rehab should require weeks on crutches with NO weight bearing! I found this site and forum and almost wanted to cry. Unstable platform bilateral squatting with perturbation. This ACL reconstruction was done as arthroscopy and an open procedure due to the drilling and the removal of the old graft and the placement of the new with anchors. Based on Abigail’s results, it’s my opinion that microfracture surgery followed by therapy that fails to identify and correct biomechanical deficits is the equivalent of treating with coffee grounds! Skiing injury. Please. Pins or screws may be needed, as well as treatment of … He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams. for my “exploratory surgery and meniscus trim”. I’ve been down this road before and have partially torn after two months after my first ACL replacement. A complete recovery (returning to sports and resuming other pre-surgery activities) can take several months or more. The rehabilitation clinician must understand the process of progressive, controlled joint loading. Stretch and hold. After one month and being able to fully weight bear, I still cannot straighten my leg fully or bend my knee past 90 degrees. Sci Sports Exerc 2008 ; 40 ( 2 ):365-377 I will repeated... 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