Micro fracture to deal with articular cartilage issue.

[Jailhouse Hopkins]

I had an MRI done to confirm what was a suspected meniscus tear. Instead a problem with the articular cartilage was found. The surgeon recommends having a microfracture procedure done.
If anyone can chime in on this, it would be greatly appreciated.

[Jailhouse Hopkins]

A second surgeon has recommended having this procedure done. I'll be having it done in early April. If anyone needs to discuss this, I'll help out as best I can.

[CJCSS15]

Hi, Can I ask how you did this injury? I have been told by a PT friend that I have a suspected meniscus tear and now some tendonosis in the biceps fem. I cannot now squat or even do the trademark starting strength bottom of the squat adductor stretch. How have you been rehabing? How do you train. Any info you can share from your experience would be greatly appreciated.

[Jailhouse Hopkins]

It happened between sets while squatting. I finished my last warm-up set and was still feeling a little tight, so I dropped down into an ass-to grass squat to stretch things out ( I do this fairly often ). There was no weight on my back. As I neared the top when standing back up, my left knee buckled, with pain experienced at the medial meniscus. I repeated the ass-to-grass movement a few more times with the same result.
During the warm-up sets, there was no indication that there was something wrong, I was feeling really good.
An MRI confirmed articular cartilage loss. All other components of the knee are fine.
As far as training, I had just finished the SS novice progression, and had just begun Wendell's 5/3/1 three weeks prior to the injury.
When I first hurt the knee, walking up stairs using both legs was out of the question. No activities were done in the first month after the injury.
It's now been two months, and I'm going to head back to the gym and see what kind of leg strength I can build before surgery.
I gave up hockey because anything more than half speed skating aggravated the knee. Oddly, downhill skiing has been mostly pain free.
Other than that, I get a lot of popping and clicking in the knee, something that did not exist previously.

[Brandon Canada]

Where is your defect? Femoral condyle, tibial plateau, patellar facet? Did the MDs describe the size of the defect? Did they discuss the types of surgical procedures (Microfracture, OATS, ACI)?

[Jailhouse Hopkins]

Femoral condyle.
2cm x 5mm
We looked at all options. Two surgeons both believe that micro fracture is the preferred option. Plus, performing a micro fracture does not burn any bridges for further procedures if required.
I live in Canada, not all surgical options for dealing with articular cartilage loss are approved here.

[Brandon Canada]

Fortunately that's a defect on the smaller side. I would spend some time becoming educated about the procedure(s), immediate post-op weight bearing status, rehab expectations and expectations to return to previous level of activity. Expectation management is very important to your recovery and your perception of success.
I'm including links to several PDFs that provide this info. Not light reading though... But it's worth it to be an educated patient!

Current Concepts for Rehabilitation and Return to Sport After Knee Articular Cartilage Repair in the Athlete
http://www.udel.edu/PT/PT%20Clinical...e%20Repair.pdf

Cartilage Restoration Part 1, Basic Science, Historical Perspective, Patient Evaluation, and Treatment Options
http://medsourcellc.com/documents/CP...ce_CR_pt01.pdf

Cartilage Restoration Part 2, Tchniques, Outcomes and Future Directions
http://www.briancolemd.com/wp-conten...directions.pdf

[Jailhouse Hopkins]

Thanks, I've read a great deal on this, including two of your links.

[GaryLane]

Just wondering on any follow up here after articular cartilage micro fracture treatment... How long until able to return to squatting? I am a fireman and recently had this done on femurall condyle. Any other places for checking people's history with this surgery and returning to squatting? Thank you.

[Jailhouse Hopkins]

I haven't had the procedure done yet. Coaching hockey and lacrosse has gotten in the way from a timing perspective. I tried a durolane injection which worked for about two months. I'm waiting on an unloader brace and plan on having the procedure done next April. Good luck with your recovery.