A tiny awl is used to create the lesions in the bone from which the stem cells are emitted as part of the clotting process. I have had ACL reconstruction on both knees, one 19 and one 18 years ago. My knee needs movement or stiffness occurs. 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. Patient will be released from the hospital the same day as surgery But most articles say there should be no weight bearing for six weeks. Right now I am trying to do sprints and basketball drills 2-3 times/week on the court just to get my wind back, and get used to “basketball moving” again. You are paying them to help you. Currently the best knee replacement involves replacing the cap (outside surface), not replacing the entire knee joint. “Rest days” or returning to the previous level of loading for a period of time should be utilized as needed. Your doctor will explain the location of your lesion so that you know which of the following programs to follow. I had done a lot of rehab immediately after tearing my ACL in 2011. It’s been tough to say the least and at 5-1/2 weeks was permitted to ditch the crutches. 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). and possibly some arthritis. whilst i was in post op in the recovery room and half asleep my surgeon mentioned something about a thing called microfracture he had performed on me during the op. The results from surgery tend to be best in the early years after the procedure, and there is evidence that the results can diminish over time.. For the first few days after knee cartilage surgery, patient recovery guidelines for cartilage repairs are similar to the guidelines for any knee surgery. Microfracture: Its History and Experience of the Developing Surgeon, Rehabilitation following Microfracture of the Knee. They did an MRI and it showed 2 cysts behind my knee, and a torn meniscus. Im barely taking pain meds, just for my PT appts.I stick to the exercises he gave me to do—-example 500 “knee bends” a day, bc that’s what promotes your cartilige growth and will help you heal quickly. Dr says to do exercises but unable to fold knee, cannot put full weighbearing on leg, knee area still swollen. i’m a trekker/ climber, and i will be climbing Mt Elbrus in Russia 18,000 ft in July, one year after my surgery. BUT. If it doesn’t he is going to send me to a cartilage specialist. I know I can walk and trust me I have tried with minimal pain but I rather it just heal. Mithoefer K, Hambly K, Della Villa S, et al. For that reason, when there is a cartilage injury, there is little the body can do to heal that injury. One may balance in the shower. No cartilage tears were apparently on the MRI pre-op. 3. I want to know why it hurts more now, then before surgry?! I put the straight leg brace that I let the hospital with on to keep my leg straight for a while. I just had surgery to remove a plate from an osteotomy I had 2 years ago. A microfracture awl perforates the subchondral bone to a depth of approximately 2 mm to 3 mm to induce bleeding. Treatment of osteoarthritis of the knee with microfracture and rehabilitation. Then 18 month later I was having problems again and was sent for an MRI scan which showed loose fragments which needed to be flushed out so I went ahead with the surgery in January thinking 2wks and all would be well. I’m resorting to following some guidelines from the Steadman Protocol, which my Physio also reads to me, and although my Physio recommended Hydro Therapy a fortnight ago, no such service has been forthcoming. I researched the operation thoroughly (study results, ideal candidates, Six weeks on crutches, the recovery being very dependent on allowing the blood clot to heal so the cartilage can regrow) before making the commitment to a long boring recovery. 2013 (insurance reasons) I was a OS nightmare he told me I had a torn acl and menicus, day of surgery I woke up to him telling me he did a microfracture and to read about it and I may want to pick up a sport like Golf. The passages I have read here are like me telling my own story. I’ll post an update in another 2 months, I hope I can run again 6 months from now but if not looks like swimming and biking is my future. My biggest pain is in the area where they drilled and specially when I straighten my leg. I didn’t know and was walking without crutches the next day.When I went to my Dr 4 days later I was told to walk on crutches.Have I done irrepairable damage or if I keep using the crutches now will it still work? Because of this, microfracture surgery is sometimes warranted to reduce pain and improve function. The reason for starting motion as early as possible is that the movement helps stimulate healthy cartilage growth. I have been bearing weight right frim the start! Havent even thought about crossfit as of yet, and havent played basketball. My knee was extremely swollen but I struggled to get through the exercises. I find that following weight bearing restrictions, elevation and ice on a regular basis, with the aid of antiiflammatories and aggressive PT have limited that occurrence to maybe once in the last 10 days. The operation is arthroscopic in nature, meaning a small scope is inserted through an incision to guide the surgeon through a video feed. At the time of my surgery, there were three options. This means crutches or walker for this time period and no significant weight on the leg or walking for this time period. Not even to beat traffic across the street. Am J Sports Med 2009;37(1):33-41. Instead patients are encouraged to perform a regular program of non weight-bearing, active assisted range of motion (ROM) activities. Amsterdam: Free University Press; 1988:727-735. I was in the best shape of my life prior to this surgery. and doc said to not concern myself with the other direction, even though I can get my heel three inches from my butt. Especially the stuff Dr. Steadman said. All is well. The last consultant I met didn’t seem to know a thing when I asked him what exercises I could do (after 6 weeks) so explained to him what the Steadman protocol was as I’d read as much on the web. Running is out for another 6 months. Some say then you should wear an off loader brace for some period. One may balance in the shower. Arthroscopy 2003; 19(5):477-484. Knee microfracture surgery is a common method used for cartilage repair. Kate, I had micro fracture surgery and a new acl put inand meniscus work done, I had buckling on occasion several weeks after. Going the through the movements of walking while crutching, just touching the ground a little bit. Its about now 7 weeks. 12. He has stolen a portion of my life I’ll never get back … and taking care of my mom is definitely out of the question for a while. I went to the doctor’s office today. Learn how your comment data is processed. The trick is be patient let the blood flow and heal, you may not get the cartilage you had growing up but its something. I am almost 4 weeks post-op now and I am being very aggressive with PT, although strengthening the quad is not as productive as I would like to see. Surgery requires “open knee” meaning cut the patella-femoral tendon. Lol. I will try aquatic techniques first to ease into it, and I will not put my crutches away until I’m convinced my knee can handle the load of walking. How difficult it was, so I weaned onto one for the next 3wks but was still in pain and could feel it catching when walking so I was panicking thinking it hadn’t worked. I was given some pain meds, and they help a little bit but I cannot get comfortable to fall asleep. I too, wish I had better educated myself. These perforations are separated by 2 to 4 mm. Has has stolen a portion of my life I’ll never get back … and taking care of my mom is definitely out of the question for a while. I am a 55 yr old female, not overweight, but not in the best physical shape before surgery. In order for microfracture surgery to be effective, the rehabilitation that follows must be performed as instructed. But how wrong was I, when I woke the surgeon told me he had done a micro fracture as it was worse than he thought which would mean me being on crutches for 6wks, I was mortified but I felt positive as I had very little pain compared to the first operation. 10. I do not have any knee pain and have returned to normal activities. Standing one-third knee bends with a great deal of the weight on the uninjured leg begin the day after surgery. Are you kidding me?!! Unlike the normal cartilage of the knee joint, called hyaline cartilage, microfracture stimulates the growth of fibrocartilage. For instance, the basketball player must be prepared for return to competition through progressive jumping and cutting activities. asked what exercises they would have me do to get back my ROM? I feel like I am the main person to blame here. I feel my surgeon overstepped his boundaries big time since I had a very pointed conversation with him about not having MF. Clin Sports Med 2010;29(2):257-265. The healing of that part is VERY minimal. These crutches are exhausting just to get around house etc. Occasionally some pool running but I hate the pool for exercise. Periodically I get a stabbing pain right above my knee cap. However, I do feel better about this surgery than I did my last one 3 years ago. Had an ACL replacement also, so I have four more months of recovery anyway. Limited strength training also begins immediately after microfracture surgery. This is very helpful to people to know more on how does rehabilitation from microfracture surgery happen. Sorry for the long post. Surgical management of articular cartilage defects of the knee. Some days very difficult to walk around. Steadman JR, Rodkey WG, Briggs KK. My fault too, I should have educated myself better. It’s been a year and 4 months since my operation. 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. Clin Sports Med 2001;20(2):365-377. When in doubt, ice, take ibuprofen and be passive; as being passive with your activity can’t do damage that inhibits scar tissue formation. HAS ANYONE EXPERIENCED A SIMILAR FEELING/PROBLEM? My knee is still swollen, and I am only icing after PT that I do 2x a day. The rehabilitation protocol utilized at our institution and outlined in the section that follows has been adapted from that described by microfracture pioneer Richard Steadman,MD, and colleagues.10. Has anyone had this occer, can you explain what it might be and what I can do without having to return to my OS? Figure 3. (Until there is another medical breakthrough similar to microfractures) P.S. i wish all micro fracture patients the best/ god bless. I’ve rehabbed dozens of NFL players following microfracture surgery and I can tell you that the first part of that myth is true. 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. This is normally after 2-4 hours after surgery. It does not have a blood supply that brings nutrients to the cartilage cells. I can get strong and regain muscles, but I can’t make the cartilage heal faster. 7. Reports in the literature are variable, but about 80% of patients find improvement in their symptoms. 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. 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. For months afterward, up to 7-10 months afterward, my knee would burn when I would do squats bearing additional weight. After the surgery I was informed I had indeed had the partial menisectomy, but also chondroplasty and microfracture for a focal articular cartilage injury. Cartilage. Microfracture is a surgical technique that has been developed to treat chondral defects, which are damaged areas of articular cartilage of the knee. Articular cartilage: injuries and potential for healing. I didn’t have physical therapy as I had thought. I will say, that I firmly believe that the success of your knee operation is completely dependant upon the skill of the surgeon. Please don’t panic when you hear the fluid squelching when you start to bend your knee a few days after surgery like I did. I recommend it. It is a common procedure used to treat patients with full thickness damage to the articular cartilage that goes all the way down to the bone. The title is ” Microfracture success depends not only on the operation but rehabilitation as well”. He offered me a shot! As so many ahead of me reported, I woke up with the news that I had lost a lot of cartilage in my trochlear groove and they had to microfracture the area. Microfracture Knee Surgery Recovery POST-OPERATIVE CARE: The key to a good result from a microfracture is staying off the leg for six to eight weeks following the microfracture surgery. It took a wile to strengthen with yoga, weights and swimming as well as losing some weight but it is better. I would not recommend the procedure. Of course this left my right leg extremely weak, but I do think it gave my knee a pretty good opportunity to heal. If not already taking place, participation in team strength training sessions is a safe reintroduction to team activity. Please be patient, don’t rush back into activity, accept that your knee will never be the same (especially if this is your first knee surgery) and try to make the most of it. It hurts because it order to reach the area where the cartilage attaches…or the root, the drilling has to go into the bone to reach fresh blood. Now I’m straightening my knee on the couch. I was on crutches, NO weight bearing for 6 weeks. I had an MRI which showed a torn meniscus At the 2 week Post Op the surgeon very briefly muttered something about a possible need for a cartilage replacement and his PA drained 75 cc’s of blood filled fluid out of my knee! Pins or screws may be needed, as well as treatment of … Heard and felt a tare in my left knee while playing back in December. 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. Panzer VP, Wood GA, Bates BT, Mason BR. I had a micro fracture surgery on 11/12/12. I went to a chiropractor yesterday. I’m really surprised to see so many people that were weight bearing so soon after surgery. Read our, Medically reviewed by Stuart Hershman, MD, Medically reviewed by Jonathan Cluett, MD, Medically reviewed by Rochelle Collins, DO, Verywell Health uses cookies to provide you with a great user experience. Good luck all. The normal articular cartilage does not heal in this area, but the body can create a healing response of a different type of cartilage called fibrocartilage. I limited the number of days a week I played and the number of games and had been feeling great; until this Tuesday. Microfracture: Its History and Experience of the Developing Surgeon. Outerbridge classification defines these as normal cartilage (grade 0), softening (grade 1), fibrillations (grade 2), fissuring (grade 3), and exposed subchondral bone (stage 4).2 Articular cartilage injuries resulting in full thickness defects to the subchondral bone have been shown to have poor healing without surgical intervention.3-5 As surgical technology has evolved, new techniques to address chondral defects have appeared. They did the microfracture… I’m 43 and highly active. A great doctor and communication can make all the difference in the world. I am 17 years old and had microfracture surgery on my left patella in march of 2013 after a volleyball injury. 1. 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. I have full range of motion. My previous 3 operations were for a torn ACL when I was 17—1 artro and 2 reconstructive. I’m beggining my info quest on what may be next to get my athletic life back. Steadman JR, Rodkey WG, Singleton SB, Briggs KK. My IT band and hamstring on the bad leg are both really tight. I would say this hasn’t worked for me. I am very concerned about how I’ll respond to putting weight on it in a couple of weeks. I was really never given the info on how difficult that recovery would be. Does anyone think im crazy that I don’t think I can go back to my trade. I’m really surprised to see so many people that were weight bearing so soon after surgery. This takes a long time to heal and may leave nerve ending exposed that need to be healed over…thus more pain. My doctors have always explained that because of the ACL replacement, there will be cartilage loss, and eventually I will have to get a knee replacement. I have not worked a day since surgery. I am currently waiting to see the surgeon again. The athlete must develop adequate strength and neuromuscular control to contend with joint stresses. MICROFRACTURE PROTOCOL The following protocol should be used as a guideline for rehabilitation progression, but may need to be altered pending the nature and extent of the surgical procedure, healing restraints or patient tolerance. I have endured this surgery once already when I was 34. I just tried to take it easy and not overexert anything. Working as a dentist, I am on and off my feet a lot. I am an avid basketball junkie and recently began playing again. I had microfracture done on my ankle 3 years ago, and I am NOT a big fan of because of the increase in pain, however, I have found no valid alternative to date. I am trying hanging it off the end of the bed, putting a dumbbell weight on it, and doing a lot of quad contractions, but nothing seems to help. My next appt with the consultant is this month which he may give me an injection but I was told last time that I wouldn’t feel the benefit for up to 4-6 months and takes 12 months to heal. Since I am a “by the book” guy, that’s exactly what I did. My knee was not in terrible pain but really throbbed and was very hot at the end of the day. Surgical techniques fall into several broad categories:  marrow stimulation, grafting, and autologous chondrocyte implantation (ACI). I feel pretty lost and not sure what to do, but if more surgery is required, that OS won’t touch me with a 10 foot pole! Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up. They say don’t carry weight, like my daughter, because the lesion is still, and will be healing for a year. Ga, Bates BT, Mason BR n't for everyone form.email } }, for the mis information I battled... 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