The Diagnosis: I am a Microfracture Surgery Candidate

Almost five years ago, I had knee problems where it was locking up and I could barely walk. This was around 5 weeks before my wedding. Dr. Christopher Behr squeezed me in then, did the surgery 3 weeks before the wedding and I was dancing on tables at the wedding. I had some good years with a lot of bicycling (2-3k miles per year) on that repair. Now it looks like I need more work in the form of microfracture surgery.

Pain back in October

Somewhere in October of 2006 I started to have a lot of pain and swelling. My key point was that I couldn’t ride my bike anymore. I also couldn’t play with the our young girls. So I went back to see Dr. Behr. He noticed a muscle imbalance and suggested I try physical therapy to help with the obvious prblems.

Physical Therapy

I worked hard in physical therapy, but there were some set backs. Our young girls and the dog all thought my exercises were play time. I also seemed to be sick a lot that fall. I did get better, but the therapists were all a little puzzled as to why I wasn’t getting a lot better.

Instead of going to my follow-up appointment with Dr. Behr, I got the flu and canceled. One thing led to another, and I never made it back. I was feeling better and riding again. I wasn’t riding at full form, but I was back and happy.

More pain again in June

Then some real pain kicked in. My knee had been feeling great and I was happy. I was riding fairly hard again and the weather was warm. I had a big meeting with work coming up, so I took a lunch ride the day before to ease the stress. I rode fairly hard, close to where I had been the previous summer. I was happy. I had no pain.

I had no pain the next day, but I had a long drive to LA. I do the drive for work a lot. On the way home I felt a knot in my leg above the knee. It was a stress knot. No big deal. I massaged it a little.

The knot didn’t go away. My knee kind of hurt. I didn’t ride anymore that week. By the weekend, it hurt a lot. By Sunday it was pretty swollen.

I called Dr. Behr’s office Monday morning and they found a slot for me in the afternoon.

Another Visit to Dr. Behr

My knee was too swollen to see much. X-rays were pretty clean so nothing looked odd. Dr. Behr drained 120 cc of clean fluid out of my knee. If it continues, he said we needed an MRI. The pain continued.

The MRI

The MRI itself was interesting. I reminded me of some of the ocean racing I’ve done on sailboats. You are in a small tube, strapped in with a lot of noise; just like trying to sleep on your off watch. Aside from that, the MRI was pretty boring. This was on a Friday.

All weekend long my knee really hurt. This was actually the first bit of uncomfortable pain that I was having.

The Diagnosis

Monday I got a message from Dr. Behr’s nurse. I didn’t get the, “your ok, everything looked fine…” message that I wanted. It was more along the lines of “When can you come in?”

Dr. Behr started by showing me some of the MRI results. I could see something, but I didn’t know what it was. I knew that he knew I wouldn’t know. That was a good indication to me that something was a little wrong.

He started easy on me with the torn meniscus. He also told me that the meniscus was not a big deal and there were “more complicated” things. Dr. Behr did an excellent job of describing what the MRI found. He also did a great job talking to me about my options. I was a little freaked out at that point. The biggest things that stuck out boiled down to either 6 or 12 months of rehab post surgery.

“Post surgery” wasn’t even something I was expecting to hear. 6+ weeks of non-weight bearing followed by months of rehab was a total shock.

It is not possible for an average person like me to evaluate a physician on their technical skills. I can judge them by their bedside manner and character. Dr. Behr is excellent on both accounts. I have much gratitude for Dr. Behr for the way he helped me understand everything that was going on.

The short summary is that Dr. Behr recommended microfracture for me. He had many reasons and weighed them with the other options too. I do not intend to cover them here.

These are the findings of the MRI:

  • Small vertical cleavage tear posterior horn medial meniscus with a small horizontal component
  • 13 mm chondral defect central weight-bearing surface medial femoral condyle with a nondisplaced flap tear located immediately posterior to this
  • 1 cm chondral defect lower femoral sulcus in the midline
  • Moderate size knee joint effusion with loose joint body/debris formation

The Following Days

The following 10 days or so brought a lot of internet research and a second opinion. The time also brought a lot of fear and emotions out for me. Realizing that you have something wrong with you is very hard.

I knew there was pain, but I didn’t think there was something wrong. Many of my thoughts became short term as I realized I wouldn’t be riding my bike again this year, I wouldn’t be running with my kids again this year, I wouldn’t be …

This was a very hard time for me mentally. Be careful with your internet research. You only heard about a lot of horror stories where the surgery didn’t work, or something went wrong. Yes, it is surgery, things can go wrong. But when they go right, many people don’t talk about them. I hope this blog is a well documented “good story”.

[edit 8/31/2007]

The Internet

Being a computer oriented person, I did a lot of internet research. Be weary of what you read. Not all of it is true, most of it is the opinion of a non-expert (like me and this site) and much of it is just worst case scenarios.

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