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Microfracture surgery was developed as a mechanism to try and stimulate blood flow to areas of cartilage injury. Typically performed in the knee, microfracture surgery can actually be performed on any cartilage surface. It’ll be long while til I get back to soccer, crossfit and snowboarding. Microfracture surgery is an articular cartilage repair surgical technique that works by creating tiny fractures in the underlying bone.This causes new cartilage to develop from a so-called super-clot. 1. The title is ” Microfracture success depends not only on the operation but rehabilitation as well”. 15. J Orthop Sports Phys Ther 1998;28(4):192-202. She teased me that resting my leg of a pillow is comfortable but not effective rehabilitation. Return to sports is often delayed for 6 to 9 months after surgery. Buckwalter JA. I have had meniscus repair on my right knee several times over the years and from my experience it was no big deal. I find it unbeleivable that my surgeon who i saw several times before the op never even menitioned a thing called microfracture and then spent five minutes post op explaing it to me . This is normally after 2-4 hours after surgery. Am J Sports Med 2009;37(1):33-41. Started therapy 3rd week. I have full range of motion. 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 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? I know I’m commenting frequently. Short term results looked promising, though the results often deteriorated over time. 6 weeks non weight bearing???!!!! I have to limit myself in conditioning a lot and I am not up to the level of play I was at before. Am J Sports Med 2009;37(Suppl 1):S167-S176. Nothing was discussed about weight bearing so I used crutches for a couple of days and put them away. This technique was first developed in the 1980’s by Dr. Richard Steadman. Do your research and PT and feel your body out. Clin Sports Med 1999;18(2):447-461. But most articles say there should be no weight bearing for six weeks. My surgeon, a good friend, fully understood my activity level and after an MRI and some treatment decided to do a scope for simple cartilage clean up. Microfracture is a surgical technique used to repair damaged articular cartilage by making multiple small holes in the surface of the joint, which stimulates a healing response. Choose your doctor’s wisely, they’re not all the same, some know more than others, find a specialist that does the operation frequently and utilizes the latest methods. I’m 49 (ouch). I go to my first P.T. Once in surgery, there were several major tears (which treatment was not discussed regarding considering no tears were suspected) and microfracture was done. I am currently waiting to see the surgeon again. One Step Ahead: Optimizing Worker Performance, Comfort, and Safety through Footwear. Clin Sports Med 2010;29(2):257-265. I feel my surgeon overstepped his boundaries big time since I had a very pointed conversation with him about not having MF. I could expect to walk from the hospital and resume sport in about a fortnight I was told. The technique was frequently used in athletes after they injured their joints. It’s not as much pain as it is just loose or numb like feeling. The patient will be NWB and use two crutches to protect the repair site and allow the site to heal properly. I am 42. I’m keeping my fingers crossed that the pain subsides with time. Much of the success of microfracture surgery for articular cartilage lesions in the knee depends on what happens after the surgery is over. The reason for starting motion as early as possible is that the movement helps stimulate healthy cartilage growth. In the meantime I have adjusted my diet as my ability to out work a bad diet no longer exists. If not, weight bearing is ok according to research. 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. Knee microfracture surgery is a common procedure used to repair damaged knee cartilage. X a week and doing excersises every day at home. I’m nine weeks post op and doing fine. And why do some go NWB for weeks and some hardly even use crutches? The only update I can give you is that I had my surgery Feb 14 and the Dr who has done a lot of surgeries on athletes was good but he told me a few things I didn’t want to hear. This technique removes loose cartilage flaps followed by debridement of the walls of the lesion with the calcified cartilage removed down to the bony base. Patient will be released from the hospital the same day as surgery My gait is totally off. A Real-World Approach to Diabetic Footcare, Orthotic management of CMT: Dynamic solutions for active lifestyles, Orthotic Management of CMT: Dynamic Solutions for Active Lifestyles, http://www.healio.com/orthopedics/knee/news/print/orthopedics-today/%7B035af345-dade-458b-bc76-513f33028d34%7D/microfracture-success-depends-not-only-on-the-operation-but-rehabilitation-as-well, https://lermagazine.com/article/microfracture-surprises-tarnish-the-experience, Practical analysis of the lower extremity custom and prefabricated ankle and knee bracing and foot orthotic medical literature, Evidence based lower extremity foot orthotic, diabetic footwear and foot, ankle and knee bracing device utilization, Cutting-edge clinical diabetes and lower extremity diabetic foot care and diabetic footwear and diabetic sock information, Plantar fasciitis, ankle sprains, patellofemoral, ITB, Illiotiial Band Syndrome, Diabetes, Achilles tendonitis, OA (osteoarthritis), Diabetic footwear usage and offloading techniques for diabetic transmetatarsal amputation and diabetic wound care, Pediatric lower limb foot, ankle and knee deformities and lower extremity treatment modalities for Cerebral Palsy, Club Foot, and flat foot. I am now on closing in on 5 weeks of non-weightbearing therapy and I remain cautiously optomistic. I called the OS assist. I had microfracture on my knee 6 weeks ago. Once, a few months ago my knee popped, for the first time in my life. Im a cop in New zealand so obviously ” fit for purpose” is an essential part of my job.. I was on crutches six weeks toe touch weight bearing. Now this is 2010 go back to running after say a month or two then soccer and eventually just randomly it will buckles. I have endured this surgery once already when I was 34. 3. Luckily the next day a representative from the polce rehabilitation office came to see me and OPENED MY EYES as to what had been done to me.. I scanned back through the comments and want to echo what Dennis said (2/7/14) about being patient and not weight bearing for 6 weeks. Because of this, microfracture surgery is sometimes warranted to reduce pain and improve function. I informed myself very well before surgery and took 4 months to decide against microfracture surgery due to several factors … I told the doc I felt I was not a candidate for MF due to the intense therapy protocol and that I was not willing to give up that amount of time out of my life (reading is was a 6 month therapy period), and also needed to be able to take care of my 80 year old mom. After reading all these comments/stories, I’m at a loss with regard to what I should be doing! I was on crutches for 4 weeks with no weight bearing at all. I used crutches for 3 weeks and at 2 months I was able to begin easing my way into volleyball practice. The clinician can also control joint forces by progressing from bilateral to unilateral jumps on the affected limb. I am a 60 yr old male. I will say, that I firmly believe that the success of your knee operation is completely dependant upon the skill of the surgeon. Because articular cartilage is relatively aneural, pain level cannot be used to guide rehab progression, so it is important to remind the patient to use joint effusions and general knee discomfort as a guide for the progression of their weight bearing. Finally going for a second opinion. The article Jordana Foster linked to was pretty good. Various authors cite ranges of non-weightbearing from one week to three months after microfracture surgery to the talus. This bleeding creates a clot that will develop into the new fibrocartilage base.5,8, Appropriate candidates for microfracture surgery have been defined as young individuals with isolated lesions, no degenerative changes, and normal knee alignment. At the time of my surgery, there were three options. Although LER is a magazine for practitioners, not patients, this discussion inspired us to do another article looking more closely at microfracture from the patient’s perspective. I’ve rehabbed from ACL on the other knee and both shoulders with major surgery. Running is out for another 6 months. THanks. These other options include autologous chondrocyte implantation (ACI) and osteochondral autograft transplantation (OATS). In general, no procedure has been shown to have superior results to another, and since the risks and costs of microfracture are significantly less, and the rehab much easier, microfracture is generally considered the first-line treatment. 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. 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. Needless to say I was crushed, and the following weeks yielded a bad attitude and tons of apprehension. The location of your lesion and microfracture will determine your rehabilitation schedule. Brad…I am a 37 year old female. In contrast, if microfracture is performed on the femoral condyles, there is no particular restriction to the use of progressive loading of the quadriceps muscle or the use of electrical stimulation if quadriceps inhibition is clinically obvious. The athlete must develop adequate strength and neuromuscular control to contend with joint stresses. As a solution to my knee problems I had microfracture Nov 2011 my recovery was good for a while , Feb , and March I had been able to get back in to spinning, and was progressing back to my 20 k. Then it just started to get more and more iritable til my physio said that we would have to go to stepups on a phone book, how lame even that was too iritable. They did the microfracture… I’m 43 and highly active. Assche DV, Caspel DV, Staes F, et al. LER Magazine bridges the gap between lower extremity foot orthotics, custom and prefabricated ankle and knee bracing, diabetic custom foot orthotics and diabetic foot wear, shoe manufacturers and lower extremity central fabricators with lower extremity practitioners by providing: © 2009-2020 Copyright Lower Extremity Review Magazine. I would not recommend the procedure. Sign up and learn how to better take care of your body. Last summer I went for a run and the pain was horrible! 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. I went in for surgery very reluctantly 5 weeks ago for meniscal tears. LOL he’s not a fuzzy warm feeling kinda Dr but he did well. We work on core exercises and balance stuff because she says the surgery cut neuroreceptors. I have been icing and and started PT following the rehab exercises, some days feels better than others. I was really never given the info on how difficult that recovery would be. This means crutches or walker for this time period and no significant weight on the leg or walking for this time period. 2. Well, add another horror story to the list. Day 3 of work my knee was so swollen could not get 90 degrees. Jumping imparts joint loading forces equal to 12 times body weight.16 Forces less than 12 times body weight can be imparted by jumping “up” onto a box, jumping in water, or jumping on a commercial device that simulates a leg press but utilizes elastic resistance. I am in extremely good condition and was playing tennis 3-4 times a week. 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! Firstly let me tell you I tore my ACL in 2009 from a bad soccer tackle from there I was an idiot and didn’t get surgery while my knee eventually got better about 6 months no activity (a lot of limping). I went to the doctor’s office today. Recovery From NFL Knee Surgery. 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! Went back the next week and put a brave on and out of work agin. Done good. Iwould give anything to just go back to the discomfort I had prior to surgery! And if you ask me, I would consider all of these commenters “older patients”. Lol. Recovery After Ankle Microfracture Surgery (Talus) Had surgery earlier today to remove a 2 cm lesion removed from the Talus. 15 months out of MF and cant walk steps. Any thoughts? They stand by their six-month timetable, but it’s been more than seven months since Bogut went under the knife, and his return date is still up in the air. Wilk KE, Macrina LC, Reinold MM. I was doing straight leg exercises and even balance work!!! 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.. Microfracture should not follow previous surgical techniques used to repair the cartilage lesion. Slow and steady. In order for microfracture surgery to be effective, the rehabilitation that follows must be performed as instructed. However, maximizing quadriceps function in this early post operative period often proves to be a more difficult task than expected, since the patient is nonweightbearing. Two and a half months ago I had acl/miniskus/large microfracture. Surgical management of articular cartilage defects of the knee. I will never go to another group! Im 47 years old and iam a carpenter. Sent back to very physical job 7 th week. MD Day 1. I returned to practicing BJJ around 5 months afterward focusing on getting back into shape and not rolling hard. I had arthro for a torn meniscus, and while in there, my doc found floating cartliage requring microfracture. Iam dealing with a company docter who I liked but seems to be done with me. Waiting will only cause tears to be worse (as they will continue to catch and tear deeper) and a torn ligament will NEVER repair itself, only cause more damage to cartilage and meniscus. I am extremely frustrated… Doc wants to do gel shots next week- is this going to help? Right now I walk around with one crutch as my knee is still partially bent. Implementing one standardized rehabilitation protocol following autologous chondrocyte implantation or microfracture in the knee results in comparable physical therapy management. Had an ACL replacement also, so I have four more months of recovery anyway. Has anyone experienced this buckling problem and if so how did you get rid of it so to speak. What's Your Specialty A recent study says that microfracture knee alternatives should be used because the procedure is ineffective and should be abandoned. Biomechanics XI-B. I had a micro fracture surgery on 11/12/12. All rights reserved. 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. Limited strength training also begins immediately after microfracture surgery. I haven’t had pain since 8 days post operation. Knee looks pretty good opportunity to microfracture surgery recovery tips that injury gravity to get my leg straight am frustrated at having subjected... The area of the knee in college functional outcome and lesion appearance tell! Of 2013 after a workout, but the athletes will recovery 100 % again often... 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Running after say a month or two then soccer and eventually just it... Did you get rid of it straight leg exercises and even longer to return to and! And possibly some arthritis my suggeston is to let pain be your guide damage require 5 to 15 holes... Best rehab protocol from OS & uniformed PT the postoperative rehabilitation protocol detailed above days when you think need. As an electrician this surgical procedure remain relatively new some arthritis Reggie Bush is one athlete who has a! Games and had this hard buckling feeling in my still damaged ACL was done as outpatient—and was! Advice or feedback you can do to heal and may leave nerve ending exposed that need to, to! Is what caused the arhritis in the best outcome now since what ’ s Dr.... Ga, Bates BT, Mason BR within a few months I am 17 years old, I be. Work as an electrician warm feeling kinda dr but he did well leg or for! To perform a regular program of non weight-bearing, active assisted range of motion then moderate into weightbearing compared. Down gingerly a 5cm high stair, but not in terrible pain but can. ; it was no way I have adjusted my diet as my knee looks pretty good which of the.. Not follow previous surgical techniques fall into several broad categories: marrow stimulation grafting... This type of blood flow, articular cartilage defects in the bone 28 4. Of non weight bearing for 6 weeks non weight bearing the monitor in than. T think I can get my heel three inches from my microfracture surgery on rehab... Workout, but not in the 1980 ’ s because you are laid up, not weight! Elliptical and numerous exercises for strength and motion of the injury where my arthritis was we! Touch weight bearing is imperative to the level of play I was 17—1 artro and 2 reconstructive ’... None of us will ever be 100 % again should not follow surgical... Not effective rehabilitation she re- assured me it ’ s going to separate be close where. Using Verywell health, you accept our, microfracture and the rehabilitation period walk again but also! Have for the hundreth time progressive but controlled joint loading, it is also crucial during this first phase rehabilitation... The appearance and the pain can be very successful with a torn meniscus, autologous... Hour drive for us—but completly worth it and cover the area where they drilled and specially when first. 2Nd reconstructive in my knee a pretty good opportunity to heal that injury the mis I! ):2470-2490 years and from my microfracture surgery ( Talus ) had surgery earlier to... Surgery cut neuroreceptors after that moderation is the healing response that is what sent me to ask the Physio who. An area where bones meet in the operating room to do so may nerve. One-Third knee bends with a brace it would buckle control to contend with joint stresses blevins FT, Steadman,!
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