Originally Posted by jgiddyup
Thanks all for the replies and I'm going to wait until my season is over as the only sport I use my knee for this time of year is golf and the Ortho reports are that it's a very small piece and hasn't gotten worse since first diagnosed.
They actually say it's the loose piece of cartiledge floating around that's causing the swelling, so I might get that scoped for removal and do the microfracture after the season.
To my knowledge, microfracture is a surgical technique that's used only for a very specific reason. Your knee has two kinds of cartilege; articular cartilage that covers and protects the bone (femur and tibia) ends, and meniscal cartilage that forms a cushioning layer *between* the bones.
As far as I know, microfracture is only used to treat problems with articular cartilage, most commonly a situation where time, injuries, or osteoarthritis have caused the articular cartilage to be removed. That results in the end of the bone being exposed (without the protective layer of articular cartilage) and leads to pain and inflammation. It's also a problem that typically will worsen over time if untreated. It's a chronic problem that usually wouldn't just "appear" from a single injury.
All microfracture involves is pounding or drilling tiny holes in the bone surface where the articular cartilage is missing. One theory is that the truma to the bone results in scarring or scabbing tissue forming over the bone end, which then helps protect the bones. Another theory, not yet proven as far as I know, is that microfracture *might* help promote regrowth of actual articular cartilage.
I could easily be wrong, but I don't think it's very easy for an orthopedist to diagnose an articular cartilage problem without actually going in a viewing the knee surfaces. I don't think this problem shows up well on MRI's, X-rays, or through manipulation. If your doc goes in and does a scope for a meniscus problem, he would see whether the articular cartilage surfaces were damaged or not.
I had microfracture done in 1998 for exposed bone surfaces on the end of my right femur. I'm a poster child for microfracture because I didn't believe for an instant that this "scabbing" idea was going to stand up to the kind of skiing I do, but I've been pain-free in that knee ever since.
My doc (the same one who did Tiger Woods' knee scope) insisted that I spend six months post-op doing nothing on that knee other than light walking/hiking or an exercise bike with no resistance. He also highly recommended a glucosamine/chondroitin mix that I've taken ever since. Whatever he did worked for me and turned a chronically very painful knee into one I can use for anything.
One thing I would suggest is to find out how many microfracture procedures your surgeon has done. My understanding is that it's a surgery that has a lot of "art" to it. If you end up needed it, I think you want someone who has done a bunch of them.