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  #21  
Old 09.06.2011, 15:11
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

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ACL can be treated with physio alone - you have to counter the lack of the ACL through building muscle in other areas to give your knee the stability it requires. But if you were going to have an op for the miniscus prob, then why the concern over ACL op? It is a very common injury in rugby, and indeed I remember a friend of mine telling me that the entire front row of the All Blacks at one point didn't have ACLs - although I've no idea if this is true.
Yes, it is very common for men to be able to work around not having an ACL. The strengthening of the hamstrings is the most important thing--because, in general, we all have stronger quad muscles than hamstrings, which is part of the problem in the first place. I know for women, because our hips are positioned wider out on our frame, it is much more difficult to work around (and be completely active) not having an ACL. It is just a physiological thing--not a sexist thing.

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There are now a number of posts that suggest that ACL is the most likely culprit in my case. So far I have not had a second opinion from a doctor, as I mentioned the doctor originally diagnosed meniscus problem and prescribed anti-inflammatory, painkillers and rest which seemed to have done the trick. Having said that, the knee has been somewhat weaker that its brother since this happened three years ago. Now though since taking up more sport I've had a recurrence and I want to get it fixed properly. The only concerns about the procedures I have hinge on the fact that I'm a bit of a wimp about doctors - white coat syndrome perhaps :-) Nevertheless, when necessary I will do what has to be done, however uncomfortable it might be.
So if you tear an ACL (whether fully or not), the ligament doesn't heal. What will happen is that the swelling will go down in the joint and you will feel "normal" or perhaps a bit weaker (as you describe). You can still do many things, especially if they are non-contact. Then, your knee will just randomly go out on you, while walking or whatever, which will remind you that you don't have the stability you once had.

And about your "wimpiness" when it comes to doctors--just listen to what (s)he has to say and then ask a few extra questions. Don't ever say, 'well wikipedia told me otherwise', just ask a few intelligent questions. This will get the doctor (hopefully) to open up a bit more about what (s)he thinks--and if (s)he is not (100%) sure what is wrong, request an MRI. They aren't cheap, but they are the diagnostic tool in this case. Once you know exactly what is wrong with you, then you can make whatever decision is best for you.

And as always, if the doctor doesn't make you feel comfortable with your situation, never ever ever let him/her operate on you. It becomes a mental thing. You have to trust the person who is cutting you open. And keep going to a different doctor until you feel that way. It will help. Good luck.
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Old 09.06.2011, 22:16
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Re: Artroscopy - keyhole Knee Surgery, feedback wanted

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No that would not be great - and could actually be libellous. We have no idea why the operation went wrong. In medical terms, the riskiest option is always surgery - that's why drugs and/or physio are always the first choice if there is no time constraint and they have a reasonable chance of success.

A surgery like that should NOT GO wrong! and for drugs ... well, fine unless you have worked in pharmacovigilace so you would fear even taking a paracetamol ...
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Old 09.06.2011, 23:23
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

I have a friend and husband who both had ACL surgery. Both had problems probably meniscus tears from playing soccer previously. Both were putting up with it until they started Tae Kown Do. Both were super-fit and flexible lot of high and flying kicks. My husband tore his ACL on a flying spin back kick. The knee was not that painful, but would not support his weight at all, just gave way to the side.
He had keyhole surgery by a great surgeon (who specializes in knees and is still writing papers) taking a graft from his hamstring. He said that he would never use a donor graft.

My friend ( all of the following is in Tae Kwon Do) had one ACL injury on one knee with a donor graft providing a quicker recovery than my husband. The she had the other knee suffer ACL, again it was a donor graft. this time it did not go well. Other recipients of that donor had problems. She suffered bone loss due to infection and more operations to try to save the graft. Eventually I persuaded her to get a second opinion from my husband's surgeon ( Ed Aronowitz who found out about the donor graft). He advised her to go back and say that she wanted it removed. She had another operation to rebuild and clean up the knee, then eventually a new graft. All keyhole except for one small incision. My husband is darker skinned but even so he has to show me the incision marks for me to see them.
So I would advise anyone against a donor graft. Also it is good to get the longer pain block to go home after the operation before the pain sets in. my husband had this and so was able to sleep well the first two nights. My friend hardly complained at all about pain, but my husband almost went nuts with it, he also passed out when they took off the bandages at the post-op check-up, he was so worried. The operation was fine- no complications.

Video featuring Aronowitz ( the second part starts as a recpa but shows the operation)
[URL="http://www.viddler.com/explore/newscayenne/videos/4/"]http://www.viddler.com/explore/newscayenne/videos/4/[/URL

After the op my husband went back to TKD but was worried about the other leg, so quit. He then went running, but that was too boring, and he didn't like banging his joints. Now he cycles and loves it. The knee looked a bit misshapen like the guy in the video for a while , but now looks just like the other knee.
He doesn't worry about the operated knee, he does worry about the other knee. Be careful on those Whipkicks!

Last edited by hoppy; 09.06.2011 at 23:40.
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Old 09.06.2011, 23:50
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

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... He had keyhole surgery by a great surgeon (who specializes in knees and is still writing papers) taking a graft from his hamstring. He said that he would never use a donor graft...
Yeah, me personally, I probably would never use a donor graft either...and I too worry about the other knee more.

But each person is very different and in some situations, using your own tissue/tendons/muscles for the repair is not possible... I went to a guy who specialized in revisions (meaning more than one ACL reconstruction on the same knee) and he gave me five options for what he could use and then advised me on what he considered the best option for my situation. I was advised against using the hamstring because it is a muscle that doesn't really grow back fully as muscle (it becomes more scar tissue than muscle) and that because I was female, young, and going onto college athletics, that I needed my hamstring full and untouched (because, as I said before, as a women, it is a weak point in our legs already).

I know now that it is very accepted to use the hamstring...so this decision is completely driven by circumstances and personal opinion (as well as doctor preference). I think all options are viable--just as long as you (meaning the person having the surgery) weigh the pros and cons of each and make the decision that is best for you...
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Old 10.06.2011, 11:47
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

[QUOTE=hoppy;1223879]I have a friend and husband who both had ACL surgery. Both had problems probably meniscus tears from playing soccer previously. Both were putting up with it until they started Tae Kown Do. Both were super-fit and flexible lot of high and flying kicks. My husband tore his ACL on a flying spin back kick. The knee was not that painful, but would not support his weight at all, just gave way to the side.
snip QUOTE]


Many thanks for your post - the description I highlighted sounds rather like my situation. I can do almost everything with the knee but lateral movement gives me problems. The knee can simply give way - it doesn't always but when it does it's accompanied by quite a fair bit of pain and I can't then do much with the knee for a while. For example, my knee gave way on me on Tuesday evening, I skipped Thai Kick Boxing yesterday as it still feels a bit weak, it's not swollen at all but feels stiff in the mornings when I get up and the tendon at the back of my knee feels a little painful when I full extend my leg - at least until it's warmed up a bit. I suspect this is muscles and tendons complaining a little about Tuesday's possible over-extension / knee give-way episode and that this will settle down soon. In the meantime I'm off to get a decent knee support bandage and an apointment at the doctor to start the ball rolling on options/operations etc.

Since the original knee incident 3 years ago I have worked to strengthen my leg muscles generally - my legs were always pretty strong as I used to do a lot of running and cycling but now they are even stronger. My goal is to get the knee fixed as good as possible and then resume my fitness program. My Thai Kick Boxing may well have to take a back seat for a while though - a shame as it's something I really enjoy, it's a great workout and (I know this sounds daft) but it's a mental thing too - perhaps quality of life aspect but the thought of not being able to do the sport I want to is mildly depressing. Perhaps I'm just too old for this sh1t at 46 and should just buy a whopping great motorbike instead :-)
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Old 10.06.2011, 12:08
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

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...My Thai Kick Boxing may well have to take a back seat for a while though - a shame as it's something I really enjoy, it's a great workout and (I know this sounds daft) but it's a mental thing too - perhaps quality of life aspect but the thought of not being able to do the sport I want to is mildly depressing.
There you go. There's your motivation to get up, get it fixed and stick to the rehab 100%...

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Perhaps I'm just too old for this sh1t at 46 and should just buy a whopping great motorbike instead :-)
You could do that too...

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A surgery like that should NOT GO wrong! and for drugs ... well, fine unless you have worked in pharmacovigilace so you would fear even taking a paracetamol ...
You don't know much about surgery do you? Any surgeon will tell that surgery can and often does go wrong. (Although clearly not their cases )

"Should not" is not the same as "will not".
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Old 10.06.2011, 12:50
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

I have a meniscis tear from a ski injury 8 years ago.

2 mri and 3 specialist visits and they all said they might be able to improve the clicking and locking problems I get. "Might" wasn't enough for me to go through the op. I don't feel pain as such, just clicking so decided not to have the operation. I had a toddler at the time and stairs at home and recovery would have been 6 weeks.
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Old 10.06.2011, 13:13
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

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I have a meniscis tear from a ski injury 8 years ago.

2 mri and 3 specialist visits and they all said they might be able to improve the clicking and locking problems I get. "Might" wasn't enough for me to go through the op. I don't feel pain as such, just clicking so decided not to have the operation. I had a toddler at the time and stairs at home and recovery would have been 6 weeks.

I can fully understand your situation and I hope your knee does not get any worse. Now that my knee has started to interfere with what I want to do I have decided to get it done, otherwise I might well have continued to put up with it.
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Old 10.06.2011, 14:35
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

[QUOTE=Louis Wu;1224270]
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I have a friend and husband who both had ACL surgery. Both had problems probably meniscus tears from playing soccer previously. Both were putting up with it until they started Tae Kown Do. Both were super-fit and flexible lot of high and flying kicks. My husband tore his ACL on a flying spin back kick. The knee was not that painful, but would not support his weight at all, just gave way to the side.
snip QUOTE]


Many thanks for your post - the description I highlighted sounds rather like my situation. I can do almost everything with the knee but lateral movement gives me problems. The knee can simply give way - it doesn't always but when it does it's accompanied by quite a fair bit of pain and I can't then do much with the knee for a while. For example, my knee gave way on me on Tuesday evening, I skipped Thai Kick Boxing yesterday as it still feels a bit weak, it's not swollen at all but feels stiff in the mornings when I get up and the tendon at the back of my knee feels a little painful when I full extend my leg - at least until it's warmed up a bit. I suspect this is muscles and tendons complaining a little about Tuesday's possible over-extension / knee give-way episode and that this will settle down soon. In the meantime I'm off to get a decent knee support bandage and an apointment at the doctor to start the ball rolling on options/operations etc.

Since the original knee incident 3 years ago I have worked to strengthen my leg muscles generally - my legs were always pretty strong as I used to do a lot of running and cycling but now they are even stronger. My goal is to get the knee fixed as good as possible and then resume my fitness program. My Thai Kick Boxing may well have to take a back seat for a while though - a shame as it's something I really enjoy, it's a great workout and (I know this sounds daft) but it's a mental thing too - perhaps quality of life aspect but the thought of not being able to do the sport I want to is mildly depressing. Perhaps I'm just too old for this sh1t at 46 and should just buy a whopping great motorbike instead :-)
I told my husband about your injury last night. His response was that " He must have partially torn it earlier-like I did. Don't you remember when I played soccer, it was painful and very swollen?".

He was about 45 at the time. He has always had motorbikes, the day the knee finally went in TKD he actually test drove a motorbike after the incident before going ot the hospital. His latest bike was an adapted BMW K 1200R. Now it just sits in the garage, as he is so hooked on cycling.

We are not doctors our assumptions could be totally wrong! You really need to find a good knee surgeon and get an MRI. The pain and rehab hard for him to tolerate, but he is so glad he had it done. Post-op he had a large cooling bag wrapped around his leg, this was attached to a machine which cooled the water before sending it back to the legbag. that seemed to help. One of my friends had very little pain, but was kind of hooked on the meds. Another could not tolerate the painkillers so had some pain before they managed to get her on the right one.

I am not sure where you live , but I know that the Balgrist Zurich has a good reputation.
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Old 10.06.2011, 14:48
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

Hoppy - did you choose your nick-name as a jab at your husband?

Thanks for your post, I think perhaps your husband is right, I may have injured it previously and finished off the job on Tuesday night. What's most encouraging to me is the reports from people like you and your husband that confirm that whilst the procedure isn't exactly pleasant and there's a reasonable amount of pain and discomfort and alongish road of physio ahead, the end result is worth it. So far, no-one has said "I wish I'd never had it done".

I'm in Budapest now, I left Zürich in 2009 and will now be looking for a decent doctor here locally. One encouraging aspect, my Thai Kick Box instructor has had an Arthroscopy - I don't know whether for meniscus or ACL - he showed me the scars on Tuesday whilst I was trying to explain what the problem was (he's Hungarian and doesn't speak any English and my Hungarian is, well crap would be the word). This chap is around 40, doesn't look especially athletic but he's immensely strong and rather good at Thai Kick Boxing as you would expect, him being the instructor

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Old 10.06.2011, 17:34
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

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Hoppy - did you choose your nick-name as a jab at your husband?

Thanks for your post, I think perhaps your husband is right, I may have injured it previously and finished off the job on Tuesday night. What's most encouraging to me is the reports from people like you and your husband that confirm that whilst the procedure isn't exactly pleasant and there's a reasonable amount of pain and discomfort and alongish road of physio ahead, the end result is worth it. So far, no-one has said "I wish I'd never had it done".

I'm in Budapest now, I left Zürich in 2009 and will now be looking for a decent doctor here locally. One encouraging aspect, my Thai Kick Box instructor has had an Arthroscopy - I don't know whether for meniscus or ACL - he showed me the scars on Tuesday whilst I was trying to explain what the problem was (he's Hungarian and doesn't speak any English and my Hungarian is, well crap would be the word). This chap is around 40, doesn't look especially athletic but he's immensely strong and rather good at Thai Kick Boxing as you would expect, him being the instructor

Cheers
for meniscus injuries you need to see how much cartlidge you have left. They do an mri with a dye injection. I didn't have much left at age 30 and to smooth out the joint they wanted to drill into my bone to produce more cartlidge. The docs in my family and a friend who had a bad knee surgery experience put me off doing it. If I had a guarentee if will be better afterwards I would do it. I can still do fitness, welll zumba, kick boxing, leg weights without fully straightening my leg, but no jogging or crosstrainers.
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  #32  
Old 10.06.2011, 19:06
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

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for meniscus injuries you need to see how much cartlidge you have left. They do an mri with a dye injection. I didn't have much left at age 30 and to smooth out the joint they wanted to drill into my bone to produce more cartlidge. The docs in my family and a friend who had a bad knee surgery experience put me off doing it. If I had a guarentee if will be better afterwards I would do it. I can still do fitness, welll zumba, kick boxing, leg weights without fully straightening my leg, but no jogging or crosstrainers.

Wow! you'd used it up by the time you were 30? Were you doing lots of high impact sport/running or what?

I wouldn't know if this is normal but it seems that it wears out fast if that's the case.
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Old 10.06.2011, 23:20
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

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Wow! you'd used it up by the time you were 30? Were you doing lots of high impact sport/running or what?

I wouldn't know if this is normal but it seems that it wears out fast if that's the case.
you need enough around the tear so they can smooth it out. My cartlidge has worn exceptionally fast. Running and karate in my school years and then wearing high heels I guess.
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Old 10.06.2011, 23:55
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

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you need enough around the tear so they can smooth it out. My cartlidge has worn exceptionally fast. Running and karate in my school years and then wearing high heels I guess.
Yes it depends on each person. I have one knee with very little cartilage left but muscle strength around the knee negates the effect as the muscle provides the shock impact protection often left to the cartilage. It depends on all sorts of things, your level of activity, sports, age etc.

If it's causing you grief and muscle strengthening doesn't help then I would have it done. Personal choice though.
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Old 20.09.2013, 13:34
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

Mroning All,
just popping back in to see what's up in CH and to give an update to this thread in case anyone's interested.
I'm now in the UK, odd to be back here after 19 years away but been back about a year now.
I had the MRI scan done and after various visits to various doctors and finally a long discussion with the orthopaedic surgeon the situation is clearer. As some of you suggested earlier in this thread, my problem wasn't "only" meniscus. The MRI and various tests show that I have a completely torn ACL, bucket handle tear on one meniscus and holes in the other plus cartilage problems and signs of arthritis in the knee - it seems I did the job properly.
I now have my surgery date, 30th September and I AM NERVOUS!
If anyone here has had Patella ACL reconstruction with meniscus repairs I'd be interested to hear how it went and what I might expect post op.
Thanks to all and Hello from Blightly!
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Old 20.09.2013, 13:54
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

I hope it goes well. I had an arthroscopy many years ago when it was a new procedure and it all went very well. It takes a while to get the strength in your knee back though, and as my ligaments were not replaced, I am banned from doing most sports ever since.
If you have them replaced, then I understand the chances or recovery are quite good, but it would also depend on the age of your body. By the sound of the issues diagnosed, I would suggest practicing sport that is less taxing on your knees in the future, e.g. swimming and cycling.
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Old 20.09.2013, 14:07
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

Thanks Lakeside.
To be honest, I did expect arthroscopy but the surgeon has told me that this procedure he has to do is rather more complicated and will not be keyhole. We'll see how it goes.
I've stopped the skiing (not much chance to do that in Norfolk anyway) and my days of kick boxing are over. I've been advised to keep away from cycling until post surgery but that was my chosen sport anyway so I am looking forward to getting back on my bike when possible.
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Old 22.09.2013, 22:08
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

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for meniscus injuries you need to see how much cartlidge you have left. They do an mri with a dye injection. I didn't have much left at age 30 and to smooth out the joint they wanted to drill into my bone to produce more cartlidge. The docs in my family and a friend who had a bad knee surgery experience put me off doing it. If I had a guarentee if will be better afterwards I would do it. I can still do fitness, welll zumba, kick boxing, leg weights without fully straightening my leg, but no jogging or crosstrainers.
I had the surgery you described. (microfracture). There are no guarantees it will be better afterwards. The recovery period is long.
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Old 24.09.2013, 22:15
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

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I had the surgery you described. (microfracture). There are no guarantees it will be better afterwards. The recovery period is long.

oh!
Well, I know there can't be any guarantees, I just have to hope for the best outcome and stick the PT regime.
How long is long for the recovery? I've heard various descriptions that ranged from 2 to 3 months to 6 to 8 months or even longer. I'm expecting it to take several months.
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Old 24.09.2013, 22:28
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Re: Arthroscopy - keyhole Knee Surgery, feedback wanted

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oh!
Well, I know there can't be any guarantees, I just have to hope for the best outcome and stick the PT regime.
How long is long for the recovery? I've heard various descriptions that ranged from 2 to 3 months to 6 to 8 months or even longer. I'm expecting it to take several months.
The recovery period does vary greatly, best to ask your doctor about this.
The important thing to keep in mind is that the cartilage created as a result of microfracture, if it is successful, is not the same as real cartilage.

Best of luck with the surgery.
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