Today it was back to the orthopedist to evaluate my recovery process. The PT gave me a letter to take along and I voiced my concern that the brace I’ve had to wear is killing my gait. I’ve been walking around the apartment without it, but it’s really annoying being out and about with it on. It’s hard to bend my knee when the brace is on correctly and it’s even harder when I’ve got long pants on and it sags down my leg. Finally, they let me take it off. The brace did give my leg a stronger and more protected feel and now with it off I can really tell the strength difference between my two legs. Hopefully I should be walking without a limp within the next few weeks. So many strangers have asked me what I’ve done to myself and I’ve got to tell them at least part of the story. A lot of them think I’ve torn my ACL, but at least with that, they can reconstruct it in the worst case and you can go back to normal, but for me the damage is done and will never be completely repaired.
The doctor advised me not to run, but at this point it’s still obvious that I shouldn’t. Again, excluding the problem of damaging the microfracture area, my leg wouldn’t last five steps of running before my quad would erupt into an inflamed mess. I’m really starting to get sick of all these appointments and long periods at the physical therapist. I understand that it’s so I can get better, bike again, and maybe run, but it’s really tiring. I adapt to the increased weights and more bike/elliptical resistance, but the recovery process is mentally straining. I remember being fed up with previous long lasting injuries where my coach wanted me in with the training room every morning doing the same kind of stuff. This is like that but on a whole new level.
The PT still wants me to continue with them on strengthening and returning to nearly full range of motion with my leg. Yesterday I got to 140 degrees, so I am getting there. I know my teammate said he still doesn’t have full range of motion in his bad leg.
There have been periodic arguments on LetsRun about the different articular cartilage repair methods, none of which are extremely robust. It seems that most people on the message board and other boards that I’ve seen get microfracture for deep cartilage tears. It’s the go-to method for an attempt at repair since it’s minimally invasive, has a moderate recovery time, and a good success rate compared to the other two techniques. Autologous Chondrocyte Implantation is a new method where a small sample of your cartilage is taken out in an initial surgery, grown in a lab, and implanted over the defect in a second surgery. They open up your whole knee to put the new cells back in and there is a ~2 year recovery time. Apparently the cartilage is much stronger than fibrocartilage so it’s better for long term results. Most insurance companies don’t cover it since it’s considered an experimental procedure. It seems that if this technique was improved/matured so that the recovery was shorter and became more mainstream so insurance would cover it that it would be a good option. In the case where my microfracture doesn’t hold up, maybe in ten years there will be a solid procedure to replace missing cartilage. I’ve also heard of stem cell injections into the knee to help repair, but that seems almost completely unheard of and there aren’t any proven results.
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