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  1. #1
    Newbie buckeyeboy's Avatar
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    Microfracture surgury

    Anyone one have any personal experiences or insight on microfrature knee surgury? I have been interested in it and I am doing some research. I would like to know if any one has had it done, and what kind of results did they have?

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    Cycling or MF?

    I had micro-fracture surgery in my left knee about two years ago. It was the second surgery on my left knee and third overall. At the time, I was only 32.

    My left knee currently has 50% of its cartilage missing, so right now I have a full fledged case of osteo-arthritis. And the bone-on-bone kills.

    My condition started when I was 14 and diagnosed with osteochondritis dissecans. That's a fancy way of saying that the underside of my femur had developed a dead area of bone that needed to be extracted. Once extracted, the hole that was vacated was drilled to encourage blood flow and thus, regeneration of the bone. I guess it worked...for a while.

    I certainly didn't help my own cause over the years (my teens and 20's) due to the fact that I used running as my primary form of aerobic (and anaerobic) fitness. I ran on pavement a lot. Bad! In my late 20's, the OA started flaring up. My knee would swell up after 15 minutes of strolling through the mall. It sucked, at such a young age, to be passed by the elderly mall walkers and know that I could never match their pace.

    My orthapedic surgeon hooked me up with an OA unloader brace. It would unload the medial (inside) part of my knee (where the bone-on-bone was happening). It worked a bit, but was extremely uncomfortable. It affected blood flow to my leg...I couldn't wear it for very long. I went on for a couple more years, regulating when and where I ran (for some reason, walking was actually more painful than running). But, in the end, I just couldn't take the pain any more.

    I'm telling you all this for a reason. Two years ago, I made two changes to help improve my situation: (1) I had micro-fracture surgery, and (2) I took up cycling. The results have been phenomenal. I still occasionally get tenderness and swelling in my knee, but it happens much less frequently and does not last as long (usually just a couple of days). It also tends to happen only after a hard cycling effort (high intensity, lower cadence). In my opinion, the cycling is what is really helping because it has built up the muscles around my knee and encourages more blood flow to the joint. Of course, the surgery may also be playing a part, but I just don't know how much. Once I ditched the crutches they gave me after having the surgery, I immediately began cycling...I mean, the next day.

    So, I'm not sure if I'm much help here, but wanted to share my experience. I know they still don't have a way to grow back cartilage in the knee. From what I understand, MF surgery is the next best thing. Does it work? I guess the docs wouldn't do it if it didn't. Pro basketball and football players tend to have it done a good bit. I have been warned that the benefits of MF surgery are short-lived - 4 years or so. I don't know how they measure such things.

    Right now, I'm in much better shape than I have been in a while. The key for me was to stop running and lifting heavy weights. I LOVE doing squats, but I cannot do big weight. If I do, knee pain starts up the next day. Same result when mashing the pedals on the bike. So, I ride with higher cadence (better anyway) and life has been pretty good.

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    Oh, and don't forget the crutches

    One more thing about MF surgery....the part that sucked the most was being on crutches for 6-8 weeks. Consider that when and if you schedule surgery. Do you want to be limping around during the Summer? Or on crutches with snow on the ground?

    Crutches are very important with MF. You MUST keep the weight off. The whole principal of MF depends on blood flow from the bone to coagulate and turn into cartilage (or at least, some thin form of it). If you put weight on it at all, your chances of having this happen are much, much less.

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    Okay couple of things. Using crutches will depend on where the microfracture is completed. Mine was done in a non weight bearing location and I did not need crutches. Most likely you will need to use the crutches as mine was an odd case.

    Timing is a good thing to think of as you will be on crutches for the bulk of the summer depending on where you live. Mine was successful and it can be a good surgery. Waiting will depend on how bad your knee is and how old you are. I am 30 and wished I did not wait to get mine done as I wasted a year trying to figure out what the problem was instead of having the surgery where they actually can be inside the knee and really see what is wrong. Good luck man.

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    Senior Member SanDiegoSteve's Avatar
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    I am now about 7 months post-op from my microfracture. I had two good sized lesions in my right knee. This was my second surgery. The first was just to clean it out.

    I was having a very hard time riding for the first part of last year. Lots of pain an swelling. I also couldn't walk very well. I tried physical therapy, getting fit on the bike, the Shimano heat molded shoes and everythign else my doctor said. We finally did the MRI and found the cartilage problems.

    The loose pieces were contributing to the swelling, but the bone on bone was a source for a lot of the pain. My body was reacting to the problems which caused the other conditions.

    Anyway, it is a long process, and I am not done yet. I am still primarily on the trainer, but I am going to start riding outside soon. If I get good results, I think I will be getting myself a new ride with a compact crank set.

    There are a lot of sites out there where you can learn about Microfracture. google for "microfracture woo hoo". I also created a blog of my diagnoses and experience. http://www.podilato.com/category/microfracture/

    If your lesions are in a weight bearing spot, you need to keep all of your weight off it. That means crutches for 6-8 weeks. Don't skimp on it. That means you will loose all of your muscle which will take a long time to build back up.

    The basic theory behind the procedure is that for small lesions (less than 3cm), you can naturally repair them. Basically, cartilage doesn't regrow. That said, the blood in your bone which has bone-marrow, will for a "scab" that is very similar to the good cartilage you should have. It is not the best, but it is yours and they are having good luck with it.
    What they do is clean out the area so it is like a pot-hole in the street. Clean to the bone with steep walls. Then they drill holes in the bone deep enough to get blood out. The blood fills the pot hole. As the blood sets up and becomes a "scab" it actually forms cartilage. This is your patch.

    This "patch" takes time to set up properly. Then, it takes time to become hard enough to actually work. This is the hard part of the surgery; time. It is arthroscopic which is the best part. The rough time for recovery is 6 months. The other procedures are full open knee with 12 month recoveries.


    So, I am 7 months post-op and doing very well. I am not pain free, but I am getting better. I do have much less pain than before the surgery.

  6. #6
    Senior Member Script's Avatar
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    Quote Originally Posted by tyrade View Post

    So, I'm not sure if I'm much help here, but wanted to share my experience. I know they still don't have a way to grow back cartilage in the knee. From what I understand, MF surgery is the next best thing. Does it work? I guess the docs wouldn't do it if it didn't. Pro basketball and football players tend to have it done a good bit. I have been warned that the benefits of MF surgery are short-lived - 4 years or so. I don't know how they measure such things.
    tyrade, Where did you get the lifespan info of four years? I've got a friend that had this done last year and there was never any indication of a short useful life. I think it could make a difference in decision making if they knew it would need to be redone? What happens after four years?

    Thanks

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