Microfracture Surgery recovery question

[DoinWerk]

I tore my ACL in my right knee in 2006, and I came back way too early from the surgery to play football.

I've had 2 seperate microfracture surgeries on the same knee in last 10 months because I did the same stupid thing, coming back from the first one entirely to quickly.

This time obviously I'm going to do what I'm supposed to, not play for 4 months at least, etc. My question is, would any sort of steroid help in the recovery of this type of surgery? I'm ignorant about steroids, but curious if they could be of any help to me recovering faster.

Thanks.

[KD735]

unfortunately, no steroids will help. In fact, the only thing proven to help is a conservative post-op recovery period... i.e.) avoiding weight bearing, gradual progression through PT when cleared, etc... I'll throw this out there however: for all of our professional athletes, we inject them with PRP ...it's a spun-down concentrate of the plasma from your own blood...it basically contains the growth factors, proteins and cells that are part are responsible for the inflammatory/healing process. We're seeing great results with this injection in a number of applications, but we can't explain why yet, largely because we just don't know to be honest. It likely has to do with concentrating a massive dose of these cells/chemicals in an isolated area. Whether these cells are responsible for the healing themselves, or if they simply recruit more cells to the area will be learned in the coming years as the research continues.

Regardless, this is the only thing we do to augment the recovery from microfracture. The more important issue here is that I just want to make sure you understand the severity of damage that must be in your knee, that has warranted multiple microfracture procedures. That is some serious damage my man.

How old are you? Reason I ask is because there ARE more options, other than microfracture. OATS procedures are one, and there is also technology to grow your own cartilage on a collagen matrix and replant it into your body. The ability to perform an OATS is determined by the location and size of your damage, and will oftentimes be covered by your insurance. The process of growing your own cartilage is much more labor intensive, and will run you anywhere from $30K to $50K (which is why we usually only offer this to the pros). There are also transplant grafts from cadavers...just throwing it out there.

Ask your ortho doc how many OATS procedures he has done. If his reply is only a couple....look for another doc with more experience. Everyone in the business knows that there are only two reasons to ever keep doing microfractures over and over again: either A, you don't know how to do anything more advanced (microfracture is the most basic, and first option in treating full thickness cartilage damage in an isolated location....and I could train a monkey to do it) .... or B, your damage is so far advanced, that your orthopod is basically throwing his hands up and saying 'oh well, he's screwed either way, so I'm going to do this and maybe get lucky, and buy him some more time, but I highly doubt it.' Either way, if I were you, I would look into a second opinion sooner rather than later.

Your poor choices during the rehab period haven't helped anything....but you're one of many patients who think that somehow not listening to us, and ignoring our advice will get you to the targeted endpoint. This is one of those cases where WE are always right, the patient is NOT. Do yourself a favor and don't ruin it this time. It's what I call burning the bridge. Once it's done, that's it. If you're young, you're setting yourself up for a lifetime of trouble, trust me. Total knee replacements are not nice....and if you want to talk about limiting what you can do....just wait until you have a knee replacement in there. That's the direction that you're heading from the sound of the multiple microfractures.

Best of luck, but it really sounds like you could benefit from a second opinion from a bigtime sports orthopod who's comfortable handling these advanced issues. Everybody can microfracture....you need someone who can present the more advanced options to you, because you ARE going to need them soon.

[DoinWerk]

I'm only 25 unfortunately. Thanks for taking the time to answer.