Microfracture surgery anyone have it done? Whats the deal?

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Just wondering when does this procedure need to carried out? Im talking mainly in the knees, dudes like Oden/Kmart/Amare have got this done but more recently CP3 has keyhole repair work.

I guess the question is best answered by someone who has gone through this surgery or someone who has a medical/orthopaedic background.

When does it become apparent that simple keyhole surgery is not gonna be enough to repair the knee and that microfracture surgery is required?

Is it simply the case of bad tears get the microfracture treatment and smaller tears get the keyhole removal treatment?


 

antonlavey

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I would like to learn more, I'm going to an American Academy of Orthopedic Surgeons yearly meeting all day tomorrow and Friday. I'll tell be sure to tell you any information I garner about microfracture surgery.
 
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yeah be interested to hear the inside story on this, ive spoken to an Orthopaedic Surgeon about it and its not that widely used more of an experimental procedure thats not common practice, but i guess pro sports Orthopaedic Surgeons would know the deal better.
 
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Just had surgery on my knee last week luckily just arthroscope to remove some inflammatory tissue.

When I was having problems with it and my physiotherapist had reached a blank after doing all he could do he suggested seeing an Orthopaedic Consultant and that because it maybe a bone issue it could require micro-fracture surgery.

From wat I was told u can have a hollow in one of the knee bones not a chip naturaly in a young person im 30 maybe a chip from a accident or some impact but either one requires micro-fracture and I guess severe cartilage damage requires the same procedure.

From wat I can gather its the severity of the damage and micro-fracture is the last thing they would do if arthroscopic doesnt work unless u have a bone injury in wich case its the only way to fix it to continue to be active on that knee.

Peace
Scottie
 
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I had it August 31st. I would say my surgery was a failure. 4 months is suppose to be the cut off, meaning you should not be feelin much pain and can begin some physical activity. its been now bout 7 months and been havin some pain. I think the Dr prolly did a good job, just sometimes the clot doesnt form the "cartilage like " material like its suppose to. I can/could have the surgery again, but bein on crutches for 2 months SUCKED.

I wish i had Amares' dr, but no dice. but my dr is the Lead on a new surgery that takes your "cells" and grows it in alab, then reinjects it into your knee...but i wasnt a canidate.

anyway my knee was really F!!!d, dr said i had the knee of an 80 year old man, arthritic sp? etc. if i was older (23) i would have to get knee replacement.

what questions do you have?
 
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just to clarify...

arthoscopic means nothin truthfully. arthoscopic just means that they put holes in your "skin" and put (metal)  tubes that can contain cameras, scrapers, drills, etc to work on the knee. 

microfracture surgery is done Arthoscopically sp? usin the above discription and scraping away the back cartilage (meniscus, which is the padding between your bones) and then drilling little holes in your femur to allow bloo d to build up where the meniscus would be. this then clots and over time forms a meniscus like substance, causing for less discomfort. 

Right after surgery, youll end up in a continuous passive motion machine. ill post a pic later.  
 
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Originally Posted by jthagreat

just to clarify...

arthoscopic means nothin truthfully. arthoscopic just means that they put holes in your "skin" and put (metal)  tubes that can contain cameras, scrapers, drills, etc to work on the knee. 

microfracture surgery is done Arthoscopically sp? usin the above discription and scraping away the back cartilage (meniscus, which is the padding between your bones) and then drilling little holes in your femur to allow bloo d to build up where the meniscus would be. this then clots and over time forms a meniscus like substance, causing for less discomfort. 

Right after surgery, youll end up in a continuous passive motion machine. ill post a pic later.  
microfracture actually doesn't have anything to do with meniscus. It's cartilage that they are trying to get to grow back. It's more of a scar cartilage that grows back but it's better than nothing.
edit: the cartilage they're trying to get reform is mainly either patella or the femoral condyle.
 
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Originally Posted by AirJapan707

Originally Posted by jthagreat

just to clarify...

arthoscopic means nothin truthfully. arthoscopic just means that they put holes in your "skin" and put (metal)  tubes that can contain cameras, scrapers, drills, etc to work on the knee. 

microfracture surgery is done Arthoscopically sp? usin the above discription and scraping away the bad cartilage (meniscus, which is the padding between your bones) and then drilling little holes in your femur to allow bloo d to build up where the meniscus would be. this then clots and over time forms a meniscus like substance, causing for less discomfort. 

Right after surgery, youll end up in a continuous passive motion machine. ill post a pic later.  
microfracture actually doesn't have anything to do with meniscus. It's cartilage that they are trying to get to grow back. It's more of a scar cartilage that grows back but it's better than nothing.
edit: the cartilage they're trying to get reform is mainly either patella or the femoral condyle.

   Just so you know...
You cant grow cartilage, which is why, the blood clot that forms (what youre callin scar cartilage) is what forms, that is better than nothing. On the actual bone that gets scraaped, there's a substance (i assume the femoral condyle, that youre talkin bout that is formed.) I may be a lil confused, but you cannot grow cartilage/meniscus thus the reasooning for microfracture surgery. so it has everything to do with it.

heres the CPM machine. I had to stay in it for the first 48 hours after surgery and then 4-6 hours daily for basically 2 months. WACK

 
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Thanks for the details, I heard the rehab is a killer on this alright 8 hrs a day would really suck but give it time dude i reckon a year to 16 months is prob a more realistic timeframe on this type of procedure. Even Amare was over 2 years before he got back to himself so i wouldn’t loose hope just yet.

From what Im hearing its what I thought, bad tears get the microfracture treatment and smaller tears get the keyhole removal treatment.

Im having my right ACL reconstructed next week, the MRI showed up a small cartilage tear (bucket handle) and my surgeon said its a small repair on that but Ive gone through the ACL recon on my left knee already over 10 rs back and its no joke. That said if you go through the rehab and stay positive you can make a full recovery, it can be more painful/longer when there is cartilage damage tho.
 
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Wow man props for anybody who can stay positive during that rehab I guess u have no choice.

Im staying positive after my surgery the real problem for me is the swelling my knee was like bowling ball when I came round and this is just minor surgery.Ive had problems with swelling b4 due to my injury wich led to the knee bein drained (asperated)twice in a year both times nearly 300ml bein taken out the joint wich the Dr and Surgeon told me is a crazy amount of fluid.

I just have about 30-40% of the movement I should do in my knee all I can do is stay with the iceing and exercises and be patiant untill the swelling is gone but it is hard Im a pretty optimistic character but it can all get a bit tedious but if I wanna play basketball n run again I have to do it.

Its my first real injury n first ever op apart from messing up my back n needing chiropractic its gonna be hard when I start getting active and doing heavy rehab not to favour my good knee n worry about the bad one,I just hope I can get my legs strong again to the point my legs feel natural  and pain free again.

Peace
Scottie
 
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No I'm positive microfracture has nothing to do with your meniscus. With damage to your meniscus you can get either a menisectomy or a meniscal repair. Depending on type of meniscal tear you have and lifestyle dictates the aproach dr.'s take to a meniscal tear.
 
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I've had a patellar debridement (arthroscopic), but that was just cleaning it out. I couldn't imagine a microfracture surgery.
 
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my understanding of micro fracture from being a sports fan is, your cartilage is so bad and thin in your knee that they drill tiny holes that encourage a blood clot to develop that simulates cartilage so that your knee isn't bone on bone ie arthritis. Not everyone always has the clots develop so sometimes the procedure is a bust, like Allan Houston it did not work for, but Amare is high flying again. Medicine is just crazy in general.
 
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Originally Posted by ToLiveandDieinNJ

my understanding of micro fracture from being a sports fan is, your cartilage is so bad and thin in your knee that they drill tiny holes that encourage a blood clot to develop that simulates cartilage so that your knee isn't bone on bone ie arthritis. Not everyone always has the clots develop so sometimes the procedure is a bust, like Allan Houston it did not work for, but Amare is high flying again. Medicine is just crazy in general.
Also as a sports fan (mainly basketball), this is my understanding of the procedure too.
  
 
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^^how many times, i have a really small tear in the lateral meniscus. The doc told me that it might heal on its own since its minor but i kept playing on it and things got worse. Now that I havent participated in any running activities for the last 3 months I feel almost normal and I can even squat on my knees without pain...the doc thinks that the reason for this could be a longitudinal tear that slips in and out of place.
 
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Technically meniscus doesn't heal on its own. What can happen with a meniscus tear is that the tear can sit in it's normal anatomic position where it doesn't cause any discomfort. If the tear is out of place it can have sort of a brillo pad effect in the joint. Causing pain and what doctors sometimes call a locked knee. If it is a minor tear normally a menisectomy will do the job. If the tear is more substantial they can opt for a repair. Repair v.s. a menisectomy is up to the Dr. and patient but out of the ortho docs that i work with only 2 out of the 7 actually do meniscus repairs. Results from a repair vary and is usually a last resort to save the meniscus before an eventual menesectomy.
edit: meniscus repairs i've probably scrubbed in about 30-35 repairs as to menisectomies probably 1000 or more. Menisectomies are probably the most common of arthroscopic procedures.
 
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