No Cartlidge on Talar Dome Lesion- what is next?

[sead]

Hi again
Can you tell me - do you remember if the lesion hurt when you were recovering?I had the cast removed at the beginning of week 7 and have been starting to walk crutches, cane , no cane - swelling icing etc -now week 10 BUT the spot where the lesion is I can feel- It does not catch but it is sore at times.
Did this happen to you? I am wondering if the microfracture worked or not??

[Tamsin]

So how's it going now sead? I remember my recovery was pretty grim and depressing at times. Are you seeing a physio?

[sead]

Hi thanks for asking - some good days and some bad- certainly not as fast a recovery as I had hoped.
Did the site of the microfracture hurt after your surgery? It is not catching but is still tender- and occasionally very sore- i am at 3 months since surgery now so wondering if you were still sore and swelling at 3 months? I am still limping and by the end of the day more so.
I asked the physio and he said the pain is my talar dome but still too early to tell if cartlidge grew or not though the doctor said i should know at 4 months or so. How long did your ankle swell for? The physio says my Bromstrom ligament repair will take up a year to totally heal and wasn't sure how long until i would know the success of mictofracture which he said is less than 50% success rate
How did your revovery go?
Thanks again
Susan

[Tamsin]

Hi Susan,

I'm trying to think about whether the lesions hurt or not. Certainly they didn't hurt like they had before the op, when it was sharp, wincing pain on every step that went up my leg. Mine were at the front of my ankle, where the ankle bones get close when you squat or pull your toes back up (called dorsiflexion), and yes I guess if I go too far in that direction now I can still make them hurt.

I did a lot of icing at the end of the day, and raising it up high. I don't remember having a great deal of swelling though.

I think what I remember most about the recovery was that I had less endurance after the operation - for at least 6 months, or probably longer, I couldn't walk as far as I could before the operation. Like maybe 1-2 miles a day - really not far at all! Maybe this was partly due to the muscles having wasted a bit whilst I was on crutches. And the pain was different. I used to have sharp pain on most steps, but after the operation it was like I could only do so much and then I just couldn't do any more. Sometimes there was swelling and other times I remember my joint just feeling warm, sore, tender and tired - all on the inside. Difficult to describe.

How will they know if the micro fracture has worked?

What exercises does the physio have you doing? I'm sure I was cycling and maybe on a cross trainer by 3 months although of course I didn't have the ligament stuff too.

[sead]

Hi i have decided nt to go to my physio anymore he puts me on stim machine then asks me to cycle with no resistance 7 min then a light massage - quite useless
I can cycle. 5 hours and have been - does still feel sore at lesion site
What I am trying to figure out is why some people are told that they can run after microfracture and some are told nt to?
My lesion is 1 cm and the loose cartlidge was removed before drilling butw removal f cartlidge that is loose or ragged seems common
Do you kow why some people can run and some cannot?
Doctor says wait six more months- that will be 11 months after surgery if still sore at that point then a special kind of CT scan and if needed anther microfracture
Any insight?

[Tamsin]

I don't know the answer but I can tell you my experience.

When I think back I was actually advised that running was ok post-op, and was on a running machine to start with during my recovery then running short distances outside - this was over a year post-op I'd say.

I never progressed beyond that however (and anyway, I was never a runner) because I had a set-back with my ankle about 18 months post-op. I can't remember exactly what happened but I was in pain again, and scared to go back to where I was before the operation. My physio advised me that running was the worst possible thing I could do for the recovery, and the orthopaedic surgeon confirmed that. My lesions were right at the front of the ankle joint where it pivots on running, which gets 8 times your normal body weight loaded onto it when you run. So it made sense to me not to put that kind of pressure on the fibro-cartilage.

I did have another MRI at that point (18 months post-op) to see what that told us. However, its not an exact science and all they were able to tell me was that there was arthritis and possibly further holes in the cartilage/some damage. Clearly my joint is never going to be perfect, and I decided to base my decision about further surgery on symptoms not the MRI. As I was managing the pain with Physio, and was actually feeling a lot better by that point I decided not to have further surgery despite the MRI. This turned out well for me as I have continued to get less pain over the years post-op, so overall I am content.

Hope some others come along with more experience.