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Microfracture, and the One Orthopedic Problem There Isn’t a Real Solution For

4 days ago, i went on a hike with a friend who was squeezing in her last days of freedom before having a microfracture operation on her knee. 2 years, 4 months and 14 days ago, i had the same microfracture operation on my knee.

you may be wondering what microfracture is. i most certainly was when i was told it was the next course of action for my knee years ago. the surgery is almost completely unheard of in the general public. there are nearly zero on-line accounts documenting the process of microfracture and the recovery. and what one reads, isn’t encouraging, promising, or helpful.  so i have decided to change that. i had my surgery at the peak of my athletic career. one day i was competing on the professional beach volleyball circuit and the next i was told (from 5 different doctors) “you may never compete again. but we aren’t certain, because no one is certain. because microfracture isn’t proven, but it also isn’t unproven, and we have no other option for you.”

since i’ve had my surgery i have been able to act as a sounding board, and a support system for two friends and fellow athletes who have come to me for advice. one of which was kelli, with whom i embarked on this 8 mile “Out With the Old, and In With the New” hike last weekend. after a few hours of knee talk, i decided that others who are faced with the decision on microfracture, should be able to join in on our conversation. therefore i will be sharing posts about microfracture, my experience, and my perspectives, in hopes that it will provide others with some sort of comfort in this frustrating process.

i will preface these posts by saying that this is not medical advice. i do not have a medical background and this is simply me sharing my personal account with microfracture. i would also like to point out that microfracture is likely a very different experience for someone who is not highly active. but for those whose happiness is greatly influenced by their activity levels, i hope these posts can provide more information on this operation and overall experience.

the day of our hike, was a good knee day. the good days, are actually one of the most frustrating parts of the decision of whether or not to pursue this procedure.  if every day were 100% miserable, it would be a no-brainer to take action.  but they are not. nothing about microfracture is 100%.

kelli and i had been discussing the good days and the bad days with her knee for months. some days an 8 mile hike was nearly pain free; and some days, she couldn’t walk at all. there was no noticeable pattern involved with her days of discomfort but she had been scaling down her activity levels to let her knee rest. kelli had already given up running and volleyball.

i wish i could report to her, and to others, that post microfracture all days became good days, but that isn’t the truth. as i explained to her, there are a greater percentage of good days, and the bad days aren’t as debilitating as they once were, but they exist. i am absolutely in a better physical place 2 years 4 months and 14 days after my microfracture, than i was before. but even at one year out, i was looking into prosthetic alternatives that would enable me to stay active. thankfully i kept my head high because the better days did come!

our hike, although 8 miles long, wasn’t extremely strenuous.  there were inclines but there wasn’t a huge elevation change causing extreme aggravation to our joints. we were happily distracted from any potential pain due to the beautiful scenery and the presence of my fun-loving pups who joined us for the day.

for people like kelli and i, these days are essential to our being. we must get outside in nature and raise our heart rate if we want to stay sane. some things can not be compromised. so when our knee doesn't allow us do those things, the only solution, is to find another option.

 

for people like kelli and i, these days are essential to our being.  we must get outside in nature and raise our heart rate if we want to stay sane. some things can not be compromised. so when our knee doesn’t allow us do those things, the only solution, is to find another option.

kelli’s doctor, like mine, recommended microfracture.  and after having shared the X-rays, MRI scans, and full details of her discomfort with other Docs to get a second, and a third opinion, she was faced with the same four options that were presented to me years ago:

  • amend your lifestyle so that you don’t use your knee for anything high impact.
    …is that a serious suggestion?
  • microfracture, although there is no guarantee it will work and if you do a google search on the operation you will be scared to death.
    …i did the google search, and i am scared to death
  • cartilage plugs, this is a new technology that is also unproven and being developed. it’s not provided by most physicians currently but if you wait a few years it could be a great alternative then
    …so what you’re saying is, this isn’t a current option? 
  • knee replacement, but we wouldn’t recommend this on someone so young.
    …right, and i am only 30, so this also is NOT an option

 

if you google microfracture, these are 3 of the top 10 sites that pop up:

“Why Microfracture Fails” by the Stone Clinic

“Greg Oden and the End of Microfracture Surgery” by SportingNews.com

“Microfracture Surgery Risky Move for Clowney”  by the Houston Chronicle

there is nothing comforting about those results. many state you should never get microfracture; however they can’t provide an alternative for people who are at a state of immobility. there is no proof that microfracture works, or doesn’t work; but after enough bad days that involve extreme swelling in the joint and an inability to walk, a decision has to be made.  which is likely why the top professional athletes mentioned in these articles also decided to have microfracture in spite of all of the negative publicity the operation gets.

i made the decision to have microfracture.  and i am glad that i did.  those words are impossible to find elsewhere on the internet in my searches; so i am hoping to provide some comfort to others who are as desperate as i was.

my perception is that every person reacts differently to the procedure and that doctors don’t know what to tell those of us who are faced with the “one orthopedic problem there isn’t a real solution for,” Dr. Mealer, Beach Cities Orthopedics. that problem being, cartilage defects. in layman’s terms, we each have a layer of “articular” cartilage that covers the ends of the tibia and femur in our knee. this smooth surface allows our joints to glide and move without friction, grinding, catching or discomfort.  once we rip portions of that cartilage off, we are bone on bone. at which point every move has friction, grinding, catching and discomfort.  it means swelling, locking up, pain, immobility, and if not properly addressed a gradual degeneration of all cartilage that remains, osteoarthiris, and an eventual knee replacement.

action is imminent so that the injury doesn’t worsen, but a proven solution does not yet exist.

i can not say that i recommend microfracture for those that are reading this. it is a decision that every individual must make for themselves. i do think there are more knee surgeries in my future and i do think that microfracture will eventually be replaced by a technology that is scientifically proven. but in the meantime, all i can say is, i had no other option, and microfracture helped me.

today 8 mile hikes, runs, and volleyball competitions are a regular part of my life. i have lost a lot of inches off my vertical and added a lot of seconds to my split times, but i am thrilled to be doing it at all.

for people like kelli and i, these days are essential to our being. we must get outside in nature and raise our heart rate if we want to stay sane. some things can not be compromised. so when our knee doesn't allow us do those things, the only solution, is to find another option.

i look forward to the day kelli’s cartilage defects have filled so that she and i can enjoy many more hikes together.

this is entry #1 of many that i plan on adding regarding my experiences with microfracture. more details to come regarding my surgery, my defects, the timeline of my recovery, my battles, and more.

 

are there any other microfracture athletes out there?

 

 

 

 

 

 

 

 

 

 

 

 

 

6 thoughts on “Microfracture, and the One Orthopedic Problem There Isn’t a Real Solution For

  1. V. Such a great post. Despite your disclosure of “having no medical background” your description and insight is fantastically accurate and on point (not that I would expect anything else). I remember you hobbling up the stairs at the strand house on your crutches with hot pink tape that first day, not sure how how things would end up with your knee and vball. So stoked to see you back out there crushing it on the court. We may need to bring you on staff at UCLA to give seminars;).

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    • Thanks for your sweet words Cas! It’s always good to have my thoughts on medical issues that are based on experiences, validated by medical people. 🙂 you were there from the beginning, from hobbling around on crutches, to trying to learn to love swimming, to eventually getting back out on the court. Thanks for your support always. Miss you, friend.

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  2. I can’t thank you enough for sharing. I’m 6 months post microfracture and still struggling with the unknown day to day, but reaching the point where the bad days are still better than the good days pre surgery. My story/recovery is nearly identical to yours (my 30th birthday was spent stumbling around on crutches) and can only hope it continues to follow with getting back into the active life my sanity depends on. Thank you for some of the most accurate and honest information I have seen out there on this surgery.

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  3. Hey Joe. Thanks so much for your message. I have made a number of posts on my blog now regarding microfracture, so hopefully reading the others will help you as well. Here is a detailed account of my recovery timeline that I put up recently that might give you more peace of mind and better expectations: https://thefirst2hours.com/2015/11/21/my-knee-microfracture-surgery-recovery-timeline/

    I am sorry you are going through it as I know it isn’t easy. But it does get better! I am pretty confident I’ll have a knee replacement some day; but I am very active in my life now! The more your look through my blog the more you will see that. I run (albeit slower and shorter distances). I play volleyball (albeit at a lower level), I hike. I ski. Honestly I am much more active than I thought I would be post microfracture. But the hard part is the mental battle, because I don’t do anything at as high of a level as I used to. As a competitive athlete, this is very hard. But it is better than not being able to be active at all.

    Feel free to reach out anytime with questions. Since I’ve started sharing these knee blogs I’ve been able to speak with many people on the topic. Of course everyone’s knee and defects are different, but generally speaking, If your knee is like the rest of ours, it will get better. It is not likely that it will ever be the same, but it is likely that you will be able to have an active life!

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