Microfracture Question; How long to fill defects??

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Topic Title: Microfracture Question; How long to fill defects??
Created On: 08/31/2006 12:26 PM

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 10/20/2006 07:03 PM

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tommyboywalker

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Well, I had a setback at just before 16 weeks postop. Knee gave out on me when I was walking and I think I tweeked the healing process at minimum and may have done some damage. I can now feel the "hook" on at least one of my defective areas with certain types of weighbearing action with quite a bit of stiffness, inflammation and moderate pain. I'm not certain that particular event caused the problem but the timing of the event with the symptoms seems more than coincidental. I'm wondering how much of a setback I will have because of this and if the healing process will hook back up and continue. It wasn't going too badly up until this point so this is disappointing. Either the healing fibrocartilage was disturbed or maybe it wasn't going to be a successful surgery anyways. Murphy's law I guess. Will see my O.S. in a week or so to discuss. I imagine he will suggest conservative treatments for a few weeks and see how it goes? I am starting to think about pushing for a replacement, I believe I would qualify for a "partial" as both of my defects are on the medial femoral condyle.
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 09/27/2006 06:53 PM

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tommyboywalker

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Thanks for your replies. I realize that I need to be patient with the healing process; I guess after 4 microfractures, I should know this huh? I'm now at 12 weeks post op. Knee is getting stronger every day. I can now take long walks up to a couple of miles without pain. Main exercise now is walking and stationary bike. I guess I'm on track but my main concern is that when I step on ground that is uneven and my knee joint is likewise in a position other than straight away, I still feel a little bit of "movement" or "shifting", presumably on the site of at least one of the two defects. It may be getting a bit better but it is hard to tell for sure as the healing process is so darn slow. I am hoping that as these defects completely FILL IN with fibrocartilage, that all knee movements will become smooth once again. It sure would be nice if there was a quick test to determine how much the defects are filled in but not aware of anything like that. Just need to wait it out. From my experience, what I've read and your input, it looks like majority of the healing occurs in the first 4 months and then some residual healing also takes place for a number of months after that. I sure hope that this surgery takes and that I'm happy with the end result as if I'm not, I think I'm going to get a replacement as I don't think I'm up for any more microfracture. As both of my defects are medial femoral condyle and pretty small, my surgeon thinks that I may be a candidate for a partial replacement so I need to start doing some research on that technique in the event I need to go to plan B. Don't want to be pessimistic but that day is coming. Not a matter of if, but when. Anybody have any experience with a partial or "compartmental"?? The success of microfracture seems to be quite varied. I have heard numbers tossed around as high as a 70-80% success rate but I'm not sure if that is accurate and I guess that would depend on what the patient/doctor called a success. Well, back to the bike. If I don't exercise, my knee feels pretty much worse so that is my motivation!
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 09/18/2006 12:23 PM

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oted3

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I had microfracture surgery 19 months ago. I worked hard at rehab and tried to do all the right things. I found that stationary bike, actually spin classes, have been great for strengthing my quads and giving me that pushoff needed for running. I tried to jog 6 months post op but just didn't feel good but after 12 months I began jogging on soft surface trials. I'm now running 5 miles, 2 to 3 times a week and spinning 2 to 3 times. I also do light stretching every morning, seems to keep stiffness from setting in. In my case it was a year before I felt like I was close to being healed. I don't plan to increase my mileage or number of runs per week. I'll never run marathons again but glad to be back running agan. Good luck
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 09/05/2006 09:51 PM

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chipperbones

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I had microfracture 4 months ago--medial condyle 2cm x 2cm, and trochlear groove 1 cm x 1.5 cm. I went back to the orthopedic last week and he said healing usually lasts 4 to 6 months and then if it worked can continue to improve for one-two years. I have been doing 45 minutes of water workouts--jogging/biking in deep water and water walking since week 3. I do the stationary bike and am trying a recumbent elliptical trainer on level 1 for just 5 minutes. My knee gets very sore, and I still ice after every workout and sometimes more through-out the day. I am now trying to train my leg to push off again and also to regain some strength. The injury was a year ago, first surgery 7 months ago for plica, then 2 months later for microfracture. I am hoping it works so I can get back on the tennis court (doubles) and teaching elem. PE comfortably. I'm 44 years young, if that matters. Dr. Hawkins (partner of Dr. Steadman, the one who invented microfracture) is my surgeon. He is in Spartanburg, SC, about 3 hours from me. You should have continued healing, and as I was told for the first 4 months, don't do anything that causes pain--that could be causing a breakdown in what you are trying to heal. Now I'm allowed to start pushing some, though he has said it will probably never be normal again. Encouraging to know that you have survived multiple microfractures with good results. I'm keeping my fingers crossed and doing everything in my power to follow protocol for the greatest chance of success. He says my case was very complex, with a 50 percent chance of success for both defects. Good luck!
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 08/31/2006 12:26 PM

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tommyboywalker

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Hi All,This is a great reference and source of information; glad I stumbled onto it and thanks in advance for any replies. I am a 48 year old veteran of microfracture. I have had it performed a total of 4 times now; my first one was over 20 years ago. I have been quite happy with the results although one must have what the surgeon calls "reasonable expectations", which means that in my case, we are considering this a somewhat temporary solution until I am sick to death of it all and cave in and get a knee replacement! Because of my past successes with microfracture (my last one was 9 years ago), I decided to give it at least one more try. While the knee hasn't been perfect between surgeries, it hasn't been bad. Moderate athletics have been tolerated pretty well including some barefoot water skiing, golf, long walks, etc. I am now 8 weeks post-op on having microfracture on two defects on the medial femoral condyle. The knee is stable and has no other issues than these smaller defects. One defect is 1 cm X 1 cm. The other defect is 1.5 cm X 1 cm. I have had a pretty typical recovery/rehab period up to this point; no unusual pain or complications of any sort. Just sore and slow and stiff as is expected. I've been swimming since week 1 at least once a day, sometimes twice; I think this is the best therapy after having this procedure and is highly recommended to al. Swimming and simulating biking in the water is non weight-bearing but gives you the critical needed movement for healing the knee and some light resistance. Started weightbearing (full) at 6 weeks; am now walking pretty normally. Taking pretty high dosage of both glucosamine and chondroitin (been taking this since '98). My question is this. Although the joint feels okay, I can still "feel" at least one of the defective areas with certain flexing/movement of that knee joint. Could be both but not sure how to differentiate which one I'm feeling. No additional pain is really associated with what I am feeling, but the joint movement is not yet smooth. I am wondering (can't remember from last surgeries) how long it took until the defective areas were reasonably filled with fibrocartilage so as to eliminate me noticing the defective areas. I'm hoping that there is still some "filling" and healing left to occur and that the knee will eventually tighten up and feel normal without noticing the defects. However, there is always a chance that this surgery wasn't successful as well. I thought I remember reading somewhere that it may take up to 12 weeks to fill properly but not sure if this is accurate information or not; can't find much on the net about this specifically.Do any of you have any experiences to share; specifically how long did it take after microfracture surgery until your knee joint felt smooth upon flexing/rotation? Thanks
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