Surgeon Performs a Microfracture and Cartilage Transplant
What did the surgery consist of?
The anesthesiologists performed a femoral nerve block (to numb my entire leg) and then I went under general anesthetic. When I woke up from the 3-4hr surgery, very groggy, my Surgeon told me the procedure. They created a bone slot in the top of my tibia to receive the donor tissue cartilage/bone graft (lateral meniscal allograft). He also created microfractures ~ouch~ in the lateral femoral condyle (the end of the thigh bone). These tiny holes create bleeding and the blood provides growth factors to help regenerate new cartilage/bone. The surgeon said he was very pleased with the donor tissue quality, size and procedure.
Where does the cartilage come from?
The donor tissue is fresh (harvested within 14 days of the donor’s passing). This particular cartilage is from a tissue bank based in New Jersey. Chronologically the cartilage is one year older then me but in pristine condition.
Day 1 Recovery
RICE protocol. Rest, Ice, Compression, Elevation. Pain medication. Lots of sleep. Home made Bone Broth for dinner. Woke up at 4am in intense pain. Desperate for pain relief and already on the recommended narcotics I hooked myself up to the CPM (Continious Passive Motion) machine that I have rented from Remington Medical. This modality flexes your knee passively (without contracting your muscles) to whatever range of motion you specify. This helped me greatly to get over the intense bout of pain. I started at a range of only 10 degrees of flexion and slowly increased it to around 35 degrees. Each night I wear a knee brace locked in at zero degrees extension.
Day 2 Recovery
RICE. CPM 6hrs a day progressing to 40 degrees flexion. More bone broth and smoothies. Started daily glucosamine sulfate for cartilage, Vitamin C and A – connective tissue, and Omega 3 fatty acids for plasma membrane/neuronal myelination and anti-inflammatory properties. Did a little bit of Ultrasound nonthermally above my knee to help break-up swelling. Also sat out in the beautiful sunshine to harness Vitamin D and neurotransmitters.
Day 3 Recovery
RICE. Bone broth. Wife made a killer chicken soup! CPM progressing to 45 degrees flexion. I had previously purchased an Aircast Cryo Cuff for all my knee icing needs. This way I have an ice pack that stays cold for up to 6 hours. I’m getting ice on it around once or twice every hour or two for 15 minutes. I also tried NMES today (neuromuscular electrical stimulation) to help wake up the Vastus Medialis neurons and fire up the brain/neural pathways (an important thigh muscle for proper patellar tracking). I also sat out in the sun again and let my wound get some fresh air and sunshine. Still waiting for my first bowel movement (a shitty side effect of surgery and pain meds :-() I tried well leg cycling for 5 minutes as studies indicate that if you exercise the ‘good’ side it helps your ‘bad’ side and I figured that might help get things moving 😉
More posts coming soon!
Follow me on Twitter and use #doctorpatient
This post is also featured on The GoodLife Blog.