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Knee Microfracture Surgery Last Hope for Some NBA Players
July 16, 2007
By: Jean Johnson for Knee1
One look at the Portland Trail Blazers’ bench is all it takes to appreciate the degree to which professional basketball players truly punish their knees. Up and down the court they go, at breakneck speeds with torque on the knee joints during lay-ups that can make an aware audience wince. Never mind that the players make it look easy. When playing hoops gets raised to the level of the National Basketball Association, men are putting their bodies on the line in a serious way. Indeed, the Trail Blazers even have their name and logo on the big plastic bags full of ice that get strapped onto players’ knees during practices.
|For every day athletes and those involved in fitness programs, the key is remembering that the knee joints are relatively fragile mechanisms. Tips on caring for your knees, adapted from the American Running Association:|
Protect knees with a sound training program.
Strengthen leg muscles to reduce load on the knees.
Stretch to reduce load on the tendons.
Avoid increasing the intensity of a workout more than 10 percent in a week.
Follow hard days or weeks with easy ones.
Regular competition is fine, but take it easy sometimes.
Train to maximum peak performance only once in each year.
For those whose knee joint problems have reached a critical level, there is what’s known as microfracture surgery.
The procedure is true to its name. First, surgeons scrape what’s left of the injured cartilage that once cushioned the facets of the knee joint. Then, using a tiny awl-like instrument, they fracture – or make tiny holes a few millimeters apart on the surface of – the exposed cartilage and bone. Microfracturing will then hopefully induce a healing response by the body. The theory is that healthy stem cells along with a fresh blood supply will converge, allowing the body to grow a new pad that while not exactly like the original cartilage, can cushion the joint sufficiently.
In time, if all goes well with the microfracture surgery and the extensive rehabilitation program it requires, the pain associated with knee damage subsides, and normal function returns. That’s what happened in Jason Kidd’s case. The 210 pound player’s knees took such a punishing throughout his illustrious career that two years ago when he was in his early thirties, he had the surgery. These days, of course, he’s back in the game and a leading player for the New Jersey Nets.
Knee cartilage “is only a few millimeters thick,” orthopedic surgeon and expert on sports injuries of the knees at Oregon Health & Sciences University (OHSU), Dennis Crawford, MD told the Oregonian, “Yet, for a 200-pound basketball player, it’s catching him every time he lands from a layup.”
Portland Trail Blazer Darius Miles clearly hopes his experience will mirror Kidd’s. Miles, who is just 25 and earns $7.75 million per year, had microfracture surgery in November 2006 and will spend the season recuperating on the sidelines. Miles tried less traumatic surgery on his knee cartilage last year, but failed to recover sufficiently to get his game back. Thus, to avoid going the route of a partial or total knee replacement that would sideline him permanently, he opted for the microfracture procedure.
Physical therapy associated with the surgery is nothing short of a major commitment. Immediately after the procedure patients are connected to a continuous passive motion (CPM) machine that keeps the joint in motion, gently flexing and extending the leg for between six and eight hours daily, sometimes while the patient is sleeping. The CPM not only helps promote healing, but it also attempts to restore full range of motion to the joint that will let players get back in the game.
“This is a way to help alleviate the pain of playing,” OHSU’s Crawford added in his comments to the Oregonian, “And how much it’s alleviated and how well you can play is hard to measure. That might be okay to get you back to playing when you’re 22 or 24. But what happens when you’re 28 or 38 or 48 is not well known.”
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