January 11th, 2013

Health N

Staff Report


Health N
photo from www.sportsinjuryclinic.net/blog

Louisville Orthopaedic Clinic shares microfracture information

As a part of the Louisville Orthopaedic Clinic, the Sports Rehab Team physical therapists are knowledgeable and trained in the latest advancements and techniques available in sports rehabilitation.

On a weekly basis, the Health N’ Sports Update will give information on prevention, recovery, and include special offers, as well as general health tips that would be beneficial to all. If there is a specific topic you’d like to know or hear more about, email future suggestions to editor@catholicsportsnet.com.

Microfracture knee surgery is indicated for athletes who present with chondral defects because of high impact activity. Microfracture surgery, with its minimally invasive technique and short recovery time, was primarily performed on pro athletes when the procedure was first developed. The procedure has now gained popularity with non-pro athletes wanting to continue and/or extend the time they can play after injury. Chondral is basically described as the cartilage that protects the ends of the bones and helps the joints glide smoothly with less friction.  Defects can include loss of cushioning between the joints &/ or deformity to the cartilage.

Causes of Chondral Defects in Athletes

Chondral defects or injury are commonly found in basketball players for a number of reasons. First, the motion of pivoting or twisting on a bent knee over time wears on the knee and contributes to the breakdown of the “cushiony” surface protecting the bones. Second, direct blows to the knee can actually cause the cartilage to break off in tiny pieces. Over time, many minor injuries to the knee can lead to the overall breakdown. Lastly, defects can occur as a result of someone that is highly active where the knees are under constant stress and pressure.

Surgery

Surgery, which stimulates new cartilage growth, is usually indicated when a patient presents with a small area of damaged cartilage in the knee joint.  This is achieved first by removing any loose and damaged cartilage through arthroscopic surgery.  Secondly, the surgeon uses a small, sharp pic (awl) to create small, microfracture holes in the bone.  In a 1-2cm involved area, 5-15 small holes are created to stimulate fibrocartilage growth. 

Recovery Process

Success of this surgery is achieved by appropriate rehabilitation with a physical therapist focusing on protecting the involved area while maintaining strength and range of motion (ROM) of the knee.  Weight bearing activity is usually limited to 6-8 weeks with the use of crutches and gradually progressed as the patient’s signs and symptoms decrease.  It may take up to 4-6 months to return to sports activity.  Professional athletes may require 1 year before returning to competitive activity. 

-Patrick Thompson-

Local High School Coaches Discuss the Topic:

Holy Cross High School Basketball Coach Kent Foushee

What are your thoughts on how to prevent injuries at the high school level?

“High school athletes must learn how to take care of their bodies because many of them are experiencing high competitive athletics for the first time since they are coming from middle school athletics. We stress proper eating habits and constant hydration in order to limit injuries and keep their bodies at peak performance levels. Many of our athletes also get taped prior to games and practices or wear knee and/or ankle braces for precautionary reasons.”

 What are your thoughts about this procedure or thoughts about it?

“I have mixed feelings in regards to microfracture surgery. Many professional basketball players, including Jason Kidd, Zach Randolph and John Stockton have had tremendous success coming back from the surgery. Others including Jamal Mashburn, Greg Oden and Tracy McGrady either never fully recovered or never were able to play in the NBA again. As a coach of high-school athletes, my recommendation for them would be to explore all their options before opting for microfracture surgery. Obviously, all surgeries are a risk but microfracture surgery seems to be one of the more high-risk, high-reward options.”

DeSales High School Basketball Coach John Mingus

What are your thoughts on how to prevent injuries at the high school level? 

“Weight training and conditioning help prevent injuries. It is hard sometimes to prevent because the body of these young adults are still maturing.”

What are your thoughts about this procedure or thoughts about it?

“I think it works at the pro level because they have the time and money to spend on rehab and the best doctors in the world. It is their job/life to get back on that playing field. The majority of high school kids play more than one sport and some are not even dedicated to one sport to care enough about enhancing their physical health.”

Louisville Orthopaedic Clinic & Sports Rehab Center

Main Office: 502-897-1794

Physical Therapy: 502-897-1790

Website: louortho.com

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Do you have a question or health issue that you would like a Louisville Orthopaedic Clinic Physical Therapist to answer? Please email your questions to editor@catholicsportsnet.com.

 

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