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Question:
I am a 29 year old male. I am in a well known band and the music we do is heavy and upbeat. I am the lead singer and I get into my performance to say the least. For a year I had pain in knee where sometimes I could not even walk because it hurt so bad. Yet I pushed forward and continued to play out with my band. I finally went to the Dr. to find out what was wrong. He suggested arthroscopic surgery which I rejected and settled for a cortisone shot. That took the pain away for many months and than we did this one show where I was very active jumping a lot and that set my knee off worse than it had ever been. I went back to the Drs. and had the surgery. When I woke up he told me that they found I had no cartridge about the size of a quarter missing from underneath my knee in the joint I guess. He did a procedure called a Lateral Release where they have out tiny holes in the bone where the cartilage was missing from to help stimulate regrowth. This surgery took place on April 22nd. I start physical therapy today. My band is signed and are album is starting to take off. I am going to have to resume my duties as a front man at some point. We have a sold out show on July 1s that if we back out of could really hold us back. With the type of surgery I just had will it be possible for me to get back into it on July 1st? Will I ever be able to perform the way I did before? I am a 'jumper' as they call it. I jump up and down during my performance
Question submitted by:
opalsuns@aol.com
| Dr. Golden |
Dr. Golden is an orthopedic surgeon and the author of the "Knee Pain" chapter in the upcoming "Manual of Pain Management". He has presented numerous scientific studies at orthopedic conferences. In addition, Dr. Golden is a member of the American Academy of Orthopaedic Surgeons (AAOS),the American Medical Association (AMA), and the Arthroscopy Association of North America (AANA).
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Answer:
The defect on the underside of your patella is known as an osteochondral defect. It can be the source of pain as well as the reason for mechanical problems in the knee, such as locking or clicking. The procedure to which you referred, the lateral release is different from your description. Perhaps you had both procedures. The microfracture techinique depends upon bringing marrow cells from the underside of the cartilage (by small pick holes) to stimulate healing. The lateral release presumes the patella, or kneecap, does not track properly when the knee bends. The release loosens the ligaments on the lateral (outside) of the knee and proports to allow the patella to track properly.
Since I do not know what was performed, you should check with your doctor. Whatever the procedure, you are only a few weeks out. And to expect to be back so soon may be a little optimistic. Perhaps by your July deadline, you will be less symptomatic. It is not uncommon for you to continue to have pain and swelling at this time. But the very high impact activities you describe do not lend themselves well to allowing the knee to heal. With high level activities, you run the risk of worsening the condition. Be sure to check with your surgeon about the rehabilitation protocol that is being used. It is always dependent on the procedure performed. Compression and anti-inflammatory medications as well as ice may help in the immediate setting.
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