Microfracture (Knee) Surgery

GavJudge

Evening all,

I just thought I'd stick up a thread to see had anyone in the Boards Universe have any experience with the above procedure.

Cycling would be my main past time and with the knee problems I've struggled to hold together a good regime over the last two years as it's progressed to the stage where stairs and even walking fast can cause discomfort.

After many visits to my physio I was referred to Ray Moran up in the Sports Surgery Clinic in Santry. I had an MRI at the start of 2011 after which nothing of note showed up so I went away and did my thing. It started to really act up again during the summer of this year so back to Santry I went for another scan after which a fissure in the cartilage behind my knee cap was found.

I'm due to have this procedure done at the end of November and as I don't know anyone who's had this done I was hoping someone out there on Boards may be able to share their experiences, good, bad or indifferent! Any feedback would be appreciated!

Thanks!

Gav

Penny77

I had micro fracturing on my hip in 2010. Had to keep with off it for 8-10 weeks. It is pretty horrid what thet do to regrow the cartalidge. I am back running now pain free(at that joint) so it was successful for me.
Good luck with it mate.

lenn

I require the same treatment lad but i put it off until i return from travelling (next year), so i'd be extremely interested as to ho this pans out. from my research i think the surgery is pretty uncomplicated and pain free but that the recovery is long and needs commitment/patience. i do know that a few top basketball players have returned to the top of their game after having this surgery, so i'm confident it works! Best of luck with it mate and keep the chin up!

SarahH2O

Need this on my kneecap,too.How did you get on with your surgery and recovery?.

Zaph

I'm actually recovering from microfracture surgery at the moment. I'm on the phone now, so I'll post some details tomorrow.

SarahH2O

Would really aprecciate that.Thanks.

fear corcaigh

I had a micro fracture 3 years ago on my knee. It was in pretty bad shape after a few arthroscopes and neglect over a few years. I was hit by a car when I was very young and although I was complaining about my knee doctors kept telling my mother it was fine.
Any way the recovery time is very slow, no weight on the joint and I mean absolutely no weight for 8 to 10 weeks, no running for at least 6 months and to this day I still cant run because i get knee pains. This is more to do with the condition of the knee rather than the microfracture.

The main reason I had the surgery was to try to prevent osteoarthritis but I was told I would need a full knee replacement before I hit 40. As a temporary measure I had plugs fitted to fill the holes where the cartilage had fallen apart.
Now when you rub your hand over my knee you can feel the plugs sticking out and I have trouble kneeling down. It was a mitigating factor in giving carpentry career.

But as for the surgery I think it definitely benefited me, I cant run but I have no problem cycling and part of the recovery process is lots of exercise bike cycling.

Good luck, hope it goes well

SarahH2O

Thanks for the reply.I have osteoarthritis only in the kneecap and this is partially dislocating because of it.Told this might be able to halt it.Was told can weight bear straight away.Worried about recovery as I have a fairly active job.

fear corcaigh

SarahH2O wrote: »

Was told can weight bear straight away.Worried about recovery as I have a fairly active job.

I know a few people that have had this and all were told under no circumstances to bear any weight on the knee joint, sounds unusual that you can bear weight immediately. I would be researching this.

The microfracture works by shattering the given bone ( think of a windscreen that's shattered, little tiny pieces every where but none fall out) and the idea is that the it grows back and joins up stronger than it was.

Mine was not painful but definitely uncomfortable and for the first 3 weeks if i wanted to bear weight I couldn't because I would get pain if I tried to put weight on it.

Zaph

fear corcaigh wrote: »

The microfracture works by shattering the given bone ( think of a windscreen that's shattered, little tiny pieces every where but none fall out) and the idea is that the it grows back and joins up stronger than it was.

Actually that's not quite how it works. What happens is the surgeon drills a load of small holes into the surface of the bone to create the microfractures. The effect of this is to cause the bone to "bleed". What seeps out is a mixture of blood and bone marrow, which contains stem cells. These form a clot over the microfractured area. The body sees this as an injury and uses the stem cells to convert the clot into fibrocartilge, which was described to me as not being as good as regular cartilage, but it's a pretty decent replacement. The reason people are told not to put any weight on the leg for 6 weeks is to ensure that the clot isn't disturbed and becomes detached. Twisting the knee is apparently the main thing to avoid, as that can cause the clot to become dislodged.

The surgery itself is pretty routine and I was out of hospital by lunchtime on the same day. Post-op pain was pretty minimal, I think I took maybe 3 painkillers in total over the first two days and have taken none since. I was told not to put any weight through the leg other than using the toe for balance, and that I'd have to do that for 6 weeks. I was given some simple range of movement and strengthening exercises to do 3 times daily. I'm now in my 6th week post-op, and have been given the go-ahead to put some weight on the leg (50% of normal) and to use an exercise bike to both strengthen the leg and increase flexibility in the joint. It'll be a while before I know how successful the surgery has been, but considering the pain I was in and difficulty I had walking just before the op, I'd say so far it's going pretty well.

Obviously this is only my own experience and the location of the microfractures in my knee may be different to you, so there may be some variations in post-op recovery, but I'd imagine it should be broadly the same. Best of luck with it.

GavJudge

SarahH2O wrote: »

Need this on my kneecap,too.How did you get on with your surgery and recovery?.

Would you believe Sarah I never got it done. They went in but didn't perform the micro fracture. The area was too small (the fissure was not the whole way through to the bone only on the surface area) to justify taking out more cartilage to do the micro fracture. I just got the meniscus tidied up and am coming to the end of my rehab for the op. Just stregthening of the surrounding muscles of the knee cap but I still getting the pre op pain unfortunately. Going back to the physio soon, she suggested that I may need another visit to the consultant if it continues.

SarahH2O

Thanks for the replies and the good wishes.
I have been doing a bit of reading and it seems that some surgeons encourage weight bearing as soon as possible.Also when it is just the kneecap it is not as weightbearing.
It will be interesting at least to see what happens:eek:.
Thanks again and I will post an update post surgery.

heyheyhey1982

I had a scope twice to clean up my knee. They didn't do a microfracture as it wasn't enough damage to do one. The defect only was a grade3 so it wasn't to the bone. My knee is pretty sh1tty now. It won't move freely with this rough spot below my knee cap. One thing you must realise about a MF is the cartilage that forms is fairly low grade and not a slippy as the original cartilage. If the damage is in the wrong place there is pretty much nothing you can do. The beacon hospital in sandy ford is now growing cartilage and if you have money this is maybe the best fix. Microfracture aren't a great fix, no sports person at a high level would have them nowadays. My knee originally had a grade 1 tear now 3 years late I have a grade 3 in the groove and a grade 3 on my knee cap. It's basically wearing it's self down to the bone.

Zaph

heyheyhey1982 wrote: »

The beacon hospital in sandy ford is now growing cartilage and if you have money this is maybe the best fix.

Do you mean the stem cell injection treatment? If so, I've had several of them and the results have been decidedly mixed. Certainly after the first one I had there was a noticeable improvement in my knee, less so with the second one and tbh nearly nothing at all with each one since (probably 3 more). As I usually have to have my knee drained every few months my surgeon now does the stem cell injections as a matter of course at the same time as there are no adverse side effects if they don't work. Each injection is fully covered by my VHI so if you have private medical insurance it may not cost you.

heyheyhey1982

Zaph wrote: »

Do you mean the stem cell injection treatment? If so, I've had several of them and the results have been decidedly mixed. Certainly after the first one I had there was a noticeable improvement in my knee, less so with the second one and tbh nearly nothing at all with each one since (probably 3 more). As I usually have to have my knee drained every few months my surgeon now does the stem cell injections as a matter of course at the same time as there are no adverse side effects if they don't work. Each injection is fully covered by my VHI so if you have private medical insurance it may not cost you.

No I had one of them injections too, I'm talking of bout the new MACI treatment. The beacon is the first to do this, they take a sample of cartilage and regrow cartilage from this. They then go back in a replant it on the area. It's the best thing as your body doesn't reject it's own cartilage. It's expensive though. Can you walk without pain?

Zaph

Haven't heard about that treatment, sounds interesting. I'll be seeing my surgeon in a couple of weeks, i must ask him about it. Both my knees are in some form of constant pain due to an accident. I have no cartilage at all in one of the knees. Basically the next X number of years are maintenance until I'm old enough to have full replacements.

heyheyhey1982

There are quiet a few methods now but they mainly work on small areas. You should ask for sure and hope they can help you. I have a deep defect in a bad place but it's quiet small. I'm in constant pain.

SarahH2O

Well I am a few days into recovery now.No microfracture after all just a good smoothing out.Also had tear in cartilage.Have been doing my physio and been able to get short walks in but am limping quite a bit but sure that will improve in good time.Knee does feel freer.

lenn

Hi, just wondering can anyone suggest a good physio in north dublin for post surgery rehab. had my microfracture surgery nearly a week ago, so its time to sort out a physio.

thanks

gaillimh

I know this an old thread but rather than creating a new one - I said I'd add to this existing one...

I'm wondering if anyone here got back to playing sports reasonably quickly after this procedure?
I had surgery 17 weeks ago in Santry.
Most of the info I have read online show that patients have to stay on crutches and avoid full weight bearing for 2 months.
Because of the size and location of my microfracture, I had no restrictions here & was allowed to bear weight fully immediately depending on pain etc. I used the crutches for 2 days I would say & was then putting weight on it fully ever since.

In my post op follow up (about a month later I would guess) the surgeon said to take it steady for a while and indicated that I could go back running around the 4 month mark. It is very hard to find any info online re rehab.

I found a rehab programme from a hospital in Nashville which indicated that you can start treadmill jogging around the 11 week mark.
I started to jog on the treadmill I would say after around 13 weeks. After a couple of jogs I fairly quickly progressed to running flat out on the treadmill.
About two weeks ago I started running on grass outdoors, and did some sprinting flat out, cariocas, twisting, turning etc.
I haven't had any adverse reaction & can sprint 100% flat out with no pain.
I've been doing some jumping on/off the step in the gym, landing on one foot, landing on both feet etc.
And doing squats, leg press machine etc.

Am now thinking I may go back soccer training next week and join in the warm up & other non-contact exercises.
Anyone else gone back to training after 4-5 months?

Just a little wary as it's hard to find info online. Would the fact that the surgeon was happy for me to be full weight bearing immediately explain why I am now able to do these activities pain free & I may be able to come back to playing sport quicker than others?
I have seen an awful lot online about guys being unable to even jog 6-7 months after surgery because of the pain but I haven't had much pain at all really. Some aches and pains at times but nothing too bad at all really.

ddullaghan

Came across this when googling microfracture surgery. Was suggested by my physio that my knee may need this procedure. Sounds like it has had great results above. One question though... Haven't been able to see any costing guild lines... What sort of cost is involved in this Op?