Last night was grim first night after microfracture surgery. I did fall asleep with the CPM machine on. Then the pain kicked and and I couldn’t sleep. That led to my first post.
Morning has Come
Now I have made it to the morning and I am feeling a little better. I have fresh ice in the ice pump machine (I don’t remember what exactly it is called) and I loosened the bandage a little. Those both helped a lot. The best thing may have been my wife massaging my calf and foot a bit.
I must say, I am being taken care of like a king. Part of me doesn’t like it because it is from not being able to take care of myself. Part of me does enjoy it. I would trade it all in to not have needed surgery again.
Surgery again? The Background
Yesterday morning I had knee surgery on my right knee. About four and a half years ago, I had arthroscopic surgery to remove some loose cartilage that was causing problems. That surgery was 3 weeks before my wedding. All went well and I was back up in no time.
About 9 months ago, my knee started to hurt a lot. I went to see my doctor again, Dr. Christopher Behr (excellent). We tried to solve it with physical therapy. The therapy went fairly well, but it was never perfect. The therapists were a little baffled at why I didn’t progress past certain levels.
About 5 weeks ago, my knee just started to swell and hurt. Things had been going well. I was back on my bike at about 90% of the fitness level I like to be at. I went to see Dr. Behr again. He drained 120cc of fluid out of my knee. A couple of days later, it still hurt and was swelling a bit. This time we went for the MRI.
Diagnosis
Once the results of the MRI came back, I went in to review it with Dr. Behr. The summary of his comment was, ” it is complicated.” I had a partially torn meniscus. That wasn’t too bad. I also had to lesions in the cartilage. These lesions are basically divots, or potholes in the cartilage. The cartilage that came out of them was floating around causing pain, the exposed bone was rubbing and also causing pain. Dr. Behr’s concern was that one of the lesions was in a load bearing area.
He presented me with three options: microfracture surgery, ACI and OATS. I am a good candidate for the microfracture since I am young, active and the divots are relatively small with steep walls. I would be lieng if I said I didn’t freak out. Microfracture can be done via an arthroscopic prcedure, but the others require full open knee operations. Microfracture has 6 months for rehab, and the others are in the 12 month range.
There are a lot of factors and variables. None of the procedures are very old (15-20 years). After research and a second opinion from Dr. Bugbee (he specializes in a form of ACI) I decided to go with the microfracture. This will clean out the junk in my knee causing me pain and give me a good chance to be on my feet and active again fairly soon.
Microfracture surgery may still fail, or at least not be perfect. Microfracture works by drilling holes/scratching the bone and letting out bone marrow blood. The blood then forms a clot that is similar to the old cartilage. It is not the same, but there has been pretty good success with it. One key tidbit is the rehabilitation. 6 weeks with no weight bearing on the leg (crutches and a lot of care), then the big physical therapy starts for another 4-5 months.
What Next?
It is hard to tell, but I plan to log and tell my story here. There will be some hard times; both physically and emotionally.
Good luck, I’ve heard the “I didn’t know thing” all too often. I knew well in advance.
Where did you have your microfracture (meaning which part of the knee)?
I just had surgery this morning and am using the cpm machine right now. Had no clue I would have microfracture as I had torn meniscus in my other knee in 2000 so I thought I knew what I was in for. I’m studying the internet and am reading your blog now.