Knee Microfracture Surgery – Should I Get It?

It was the spring of 2011 when I first found out that I had a cartilage defect in my left knee. Prior to this point, I had never had any instances of pain in either of my knees. In relation to my entire body, my knees were my LAST concern! At 35 years old, my body had taken a beating through years and years of sports. I played football, basketball and baseball in high school. I went on to college and played baseball there for four years. After college, I continued with baseball, basketball leagues and eventually softball leagues and tournaments. My knees were logging hundreds of hours each year on courts and fields. In the mean time, I had also begun to pack on extra muscle weight by working out at the local gym. The combination of all these things ended up causing me to wake up one morning with a very sharp pain in my left knee (I had a basketball game the previous night). As with other body aches and pains that athletes continually deal with, I decided to wait and see if the pain would reside on its own. After two weeks of no improvement, I ended up inside of an MRI machine, praying for reasonable results. The visit with the doctor brought out words and phrases like “articular cartilage defect”, “pothole”, “debridement”, “awl” and “microfracture surgery”. I had no clue what any of these terms meant! Before I knew it, I was attempting to decide whether or not to have the dreaded microfracture surgery. I say dreaded because this surgery has been know to be a VERY DIFFICULT surgery to come back from. In fact, many professional athletes’ careers have been ended after microfracture surgery. For example, A’mare Stoudemire is a well know player for the New York Knicks who recently underwent microfracture surgery. Although he did make a comeback this year, he unfortunately has had to go back on the disabled list due to knee pain.

In researching the history of the surgery, I knew that there were plenty of risks that went along with it. At the time, my only goal was to get it fixed and get back on the softball field. I decided to go ahead with the surgery, and had it done in July of 2011.

The procedure itself is actually quite simple. The doctor can perform the surgery arthroscopically, which helps with some parts of the recovery. The concept behind this surgery is based on the fact that the cartilage defect in the knee does not have the ability to repair itself due to a lack of blood flow. This cartilage defect, or “pothole” as some doctors call it, causes friction between the femur and tibia. This friction causes bone bruises and arthritis type symptoms. In surgery, orthopedic doctors will prep the area by removing any damaged or loose articular cartilage near the defect. The doctor will then take an awl and drill several small holes into the bone below the defect. These holes will basically begin to bleed and eventually a clot will form. The hope is that in time, this clot turns into a fibrocartilage, which will replace the missing cartilage and effectively eliminate the pain.

I can say that two years later, I still have my doubts about whether or not I should have had the surgery in the first place. The entire process has become very personal for me, so much so that I have developed my own website dedicated to the surgery, My hope is to develop a support community for anyone who has had or will have this surgery. There have been several things that have helped me along the way and I’m sure there are several other stories and ideas out there!

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