Not told about microfracture until after surgery?

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Topic Title: Not told about microfracture until after surgery?
Created On: 03/28/2007 11:49 AM

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 01/09/2008 07:33 PM

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chellekaynva

Posts: 47

Hi Jason, I am glad to see that you are doing well after your MF. I too had this procedure done 15 months ago, without prior warning.......I did however give my surgeon the go ahead to do what he had to do to fix the problem.....I was in major pain all the time! After the 6 weeks NWB I did VERY well!!! i have very little to no pain for almost a year. Now however I am having severe pain again (I had 3 VERY large lesions that were grade 4 prior to surgery). I am undergoing Synvisc injections as a last resort. ..........All I can say is continue to be diligent but be careful with impact activities... ie jumping etc
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 12/03/2007 11:35 PM

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jason1234

Posts: 7

It is now, for me, 9 months post-op and knee is pretty much back to normal although it is still weaker than the other knee and I am not back to full court basketball and running. I hope to be there soon.The biggest thing for me was physical therapy and -- for me -- stretching my hamstring. Despite being very diligent with physical therapy, I was still experiencing significant pain in my knee. However, once I religiously stretched my hamstring several times a day, the pain subsided very quickly. I am still not happy my surgeon did this procedure without any discussion of the possibility before hand. But as things get closer to normal, I am thinking more that this is water under the bridge.Make sure you do your strengthening exercises and also make sure you stretch your hamstrings.
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 11/12/2007 04:15 PM

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micro123

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Hi Jason,I am 8 weeks post-surgical with what was supposed to be a partial meniscectomy, which turned into microfracture surgery. My doctor never discussed the possibility of microfracture with me. In fact, I chose him because another doctor had recommended microfracture surgery, and I didn't want to go through with it, being in a self-employed occupation (I was told at that time that I would have to be on crutches for 6 weeks). After going through the surgery, the doctor said that I could go back to work after only one week on crutches. He said that his arthritis patients didn't need as much time on crutches after microfracture surgery. After all the physical therapy that I have gone through, I am still in a lot of pain. I believe that no doctor should ever perform a procedure without the patient's consent, especially something as unknown as microfracture surgery (not always successful). A new doctor has just told me that he would have just washed the knee and closed up, if he thought the best procedure was microfracture and he had not discussed it first with me. I thought that the doctor who performed this surgery had read the MRI, which showed the arthritis in my knee, but apparently he was too busy and did not take the time. Any thoughts?Michael
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 08/03/2007 06:06 PM

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mamawood2000

Posts: 8

Hi Jason,I think almost all of us Microfracture patients find out after the surgery. I had the left knee surgery done in 2005 and the right knee (Microfracture) earlier this year. I was expecting to be walking the next day, same as the first time. Not so, when I awoke from surgery and my husband told me I would be non weight bearing for six weeks I was shocked. At least I was able to rehab without the worries of a job or small children. I do not know what some patients do when they have obligations to work and children.It has just been six months since my surgery; and all is going as expected. I will be thrilled when I can walk several miles and be pain free.Good luck to you during your recovery. Keep your chin up, the time does pass, I promise.
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 07/24/2007 02:34 PM

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TomM

Posts: 2

My doctor warned me of the possibility of MF in my pre-surgical consult. He said that based on my MRI and symptoms it didn't seem likely but that I should prepare for the possibility all the same. I was a little shocked when I woke up to find I'd undergone MF but the surgical images clearly showed I'd torn my articular cartilage down to the bone--the conditions under which he told me MF would be necessary.
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 07/06/2007 08:20 AM

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Augur

Posts: 10

I went in for the MF procedure. Based upon convos with the doc, I expected to be able to walk out and return to work in a couple days ... a week at the latest.but, the tear was larger than expected (based upon MRI) and immediately after waking up I was told to NWB for 4-6 weeks.I was like, ummm ... what just happened?!?!I was not prepared for this scenario and it hit at the worst possible time as I grogily woke up from surgury. I consider myself an informed patient and discussed the procedure at length with the doctor. NWB was not even mentioned as a remotely possible outcome. Perhaps the tear was located in a "good place" in my knee for MF or the doc's confidence was too high. In any case, I also have to share in the blame here because I wanted to see the rosy picture.So I woke up with NWB instruction and had no crutches ... my DW had to scramble to pick up a set at the local drugstore, no arrangements with work ... I was fortunate the have vacation time available and an accomodating employer for the rest of the time. Talk about change management issues!!!In hindsite, it all worked out and I'm glad the procedure was done, the NWB was required and the healing has progressed. I'm currently almost 9 months post-op and starting to introduce some of my old lifestyle activity again (i.e. light running - 3miles, 3x/week). My knee is tolerating everything pretty well so far, stretching and strength training being two really important keys. I hope this helps.


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 07/05/2007 05:06 PM

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drspankie

Posts: 2

A lot of folks seem surprised to wake up with MF, like they were not informed. Not my experience. doc informed me of the MF possibility prior to arthro- said it could be 6-8 weeks NWB if needed instead of the 2-3 days I expected from arthro- I consented in writing before the surgery. Doc said MF is a good risk to prevent; 1) more damage to the remaining cartilage and bone, and 2) more extensive (inevitable) surgery in a few years. Doc did not tell me, however, about the full-recovery period- 3-6 months- nor about the difficulties of recovery (like, not driving for two months), or the ongoing pain. My fault for not asking. So, now I ask.
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 06/05/2007 10:17 PM

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Kripple

Posts: 17

This is nuts. Why are doctors performing elective surgery on ppl? Microfracture is not a universally proven procedure for everyone and quite frankly the patient might actually be interested in carticel or hgh.
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 05/06/2007 09:47 PM

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jnutter

Posts: 22

hi jason 1234...I too had the micro fracture surgery while in for an ACL reconstruction...i did not know of the MF prior to surgery...but it has been two years since the procedure and i am feeling great!! I am 55, female and i am back to skiing and horses and walking and running and all without pain, stiffness and that crunching sound that i always heard in my knee when walking up the steps. I was NWB for 8 weeks, with two to three weeks of gradual weight on my knee...I spent nearly a year in PT and was a model student. I believe that paid off for me...you will be fine, if you do as your PT says...riding bike was the best that i could do for my knee...i did a stationary bike for months..I admit, that now I am less inclined to do the stationary bike, but it was great as I recovered from the MF and ALC reconstruct....there is life after and it is good...I wish you well...


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jnutter
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 04/06/2007 05:10 PM

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jason1234

Posts: 7

Thanks -- you've given me some hope. Good luck in getting back to both!
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 04/01/2007 09:41 PM

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Augur

Posts: 10

No problem!My intention was to write something up in more detail and with more historical reference, but I'll try to summarize quickly.My ROM is currently 0° (extention) and something >130° (flexion); extention is at parity, we haven't checked flexion in a while as the knees were within a couple degrees of each other. I believe with the stretching work we've focused on lately, I'm probably 135 - 140° at this point and close to equity. Stengthwise, I'm better than before the injury but some of that is probably because I didn't lift pre-injury. In any case, I'm not breakin any records in the gym.PT strength program was limited to 3 cybex type machines. I'm currently doing 3x15 reps of 240# (leg press), 120# (hamstring curls) and 140# (4-way hip).Additionally I do calf-raises (3x20), stepovers (3x20 8" box), ball bounces (3x20 6# ball standing on a balance board) and balancing on an air cushion (3x30sec). We had started doing lunges and weighted stepovers, but that irritated the patella tendon so we backed off.Cardio work includes elliptical (30 minutes 3x/week) and walking (3miles 2x/week).PT ended last week. I've transitioned everything to the local gym and have instructions from my PT for the next 6 - 9 months. Goals are to continue strength work 2x/week and build cardio work to tolerate running.Longer term, continue training toward possible return to running races and playing soccer. Initial prognosis after surgery was 50:50 on this goal. Doc feels we've increased my chances significantly in the first five months :-)


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 04/01/2007 02:41 PM

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jason1234

Posts: 7

Thanks very much for your post. I certainly would be interested in others surgical results with MF. One question -- you indicated you are 5 months post-op and achieving some success. While every case is obviously different I would be interested in where you currently are in terms of returning to the ROM and knee strength you had pre-op.Thanks very much.
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 03/31/2007 03:53 PM

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Augur

Posts: 10

To be honest ... I think this question (as with most posted of similar context) is better directed to the doctor. Discussion of what was done, why the decision was made and how to promote recovery is critical to you understanding.Regarding the query, I'm not sure if anyone not directly involved in the surgery can comment reliably other than to post their own specific surgical results ... which may not pertain to your caseFor what it's worth (and lacking any evidence that the surgeon messed up), it sounds like a good choice to do the MF while you were on the table for the meniscus repair. My experience with the orthoscope included a MF procedure which was unexpected, but in the end prudent. I really struggled with the unexpected procedure and associated NWB restrictions. I lost significant ROM and strength in the knee. I'm currently 5 months post-op and have started to make good progress via the PT and exercise program. My attitude on the MF has changed parallelling this success.Is any of this pertinent to your case? I have no idea, probably not.Everyone here has (or is currently facing) significant hurdles in joint recovery and use. I hope this help in some way.


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 03/28/2007 11:49 AM

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jason1234

Posts: 7

I recently under went arthroscopic surgery to have a portion of my meniscus removed b/c of a tear. Another family member had it done so my expectations were that the surgery would be relatively minor, with limited down time. Prior to the surgery, my knee only experienced pain after a run or playing basketball. I wasn't ever sure I should have the meniscus surgery and the OS wasn't pushing it.In any event, during the surgery, the OS found my cartilage to be significantly damaged with the result that he not only performed the partial meniscus removal, but some other procedures as well, including microfracture surgery. Needless to say, the nature of the procedure and the rehab is significantly greater with the microfracture than the surgery I was anticipating as I am now on crutches NWB for 6 to 8 weeks.My questions is whether it was appropriate for the doctor to decide during the surgery to do microfracture surgery when we never discussed the possibility prior to the surgery. He said the MRI did not reveal the cartilage damage. Should he have gone and performed the microfracture without any discussion with me or should he have sewn me up and when I came out of OR told me the issue and let me decide whether and when to do the microfracture surgery.Thanks.
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