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Old 09-13-2012, 11:46 PM   #1
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OCD microfracture surgery questions

I am 28 (non-smoker) and have an OCD on my medial talus dome. After speaking to a good ankle surgeon I was told we would remove the fragment, do a microfracture procedure and fill the hole with chondro-gide.

I had this scheduled for the 20th of this month (so less than a week away) but I have just been told that funding for the chondro-gide (I believe it is similar to that Denovo NT) in Australia has been pulled. I am going to be out of pocket for this procedure anyway, but I had not factored in the cost of the chondro-gide (I didnt know it would cost multiple thousands extra!!).

He recommends I still go ahead with the microfracture procedure but due to the OCD being larger than 10mm in diameter apparently the success rate is just 45% (he says).

So, I have a few questions for those who have experienced this procedure:
Is the success rate really just 45% (I am defining success as being able to walk and jog without pain, I am not an athlete!)?
How much more success would I have with chondro-gide?
Can the procedure make it worse than it is now (I have a stage 3)?
Should I go ahead with it now?

 
Old 09-14-2012, 03:23 AM   #2
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Re: OCD microfracture surgery questions

It is 14mm x 10mm

 
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Old 09-14-2012, 06:10 AM   #3
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Re: OCD microfracture surgery questions

sorry for you to be in this position. I have no medical training and I cannot post any percentage of failure. I had OCDs in both ankles. Both were large like yours. Both I did microfracture with drilling to promote new growth. Both failed and got larger, one got very messed up. The whole thing turned into over a five year period of surgeries and recoops. I have now had 2 successful OATS one allograft and one autograft. I will say the allograft was much easier to recoop from and works more smoothly. I believe my first surgery was Feb 06 and today I start a new job (have not had a good one in 5 years due to inability to walk) And I go to gym daily I do eliptical and tredmill and feel very strong again. I do not run and have not tried to run because after the failures I don not want to go backwards with these legs. I try to stick with non impact.
If I could go back I would go straight to the oats. I think it would save me a few years. I would advise you not to rush into any surgery, do a bit of research first. One thing you can do to get an idea of what your damage is, is draw it out. 14x10 is quite a large hole. Have that doc draw the size of your talus on paper and then draw the OCD over it in the area where it is. I think you will be very surprised at how big that hole really is. Once he does that find out if he really thinks he can fix it. and if he would do the same to himself or his child. I found out that my doc wrote "this patient is a good candidate for OATS" on the very first visit. I never even heard about failure or was given any indication of this when I went for the first microfacture, just everything will be fine. I just was so happy at the possibility of being fixed I did not do research before.
All the best for you for a quicker recovery. It is alot to consider, take your time.

 
Old 09-14-2012, 06:35 AM   #4
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Re: OCD microfracture surgery questions

Yea based on the CT scans it is quite large. I was worried by you saying that they got larger and worse after the micro-fracture. Can removing the fragment and doing the micro fracture procedure make things worse than leaving it as is? Or do these things get worse over time if left as they are?

I have basically stopped doing any high impact activities which keeps things under control at least. I don't mind not being able to run anymore but being able to walk and lightly jog on it would be what I consider a success.

 
Old 09-14-2012, 07:09 AM   #5
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Re: OCD microfracture surgery questions

most doctors will not do a mri or ct till about the 6 month mark so i am not sure if the increased size is a direct result. I do know that there are several others that have their lesion get larger. I know the one that got the worst for me, I knew within 2 weeks of trying to start weight bearing. I had issues right away and insisted that there was a problem. Doc did not do new mri till 6 mos out. Turned out I was right there was problems. I worked for 3 months on a very damaged ankle. But could not say exactly when the worst damage happened.
Gotta get ready for work!!!! im nervous

 
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Old 09-14-2012, 08:25 AM   #6
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Re: OCD microfracture surgery questions

That sounds really bad

The surgeon I have is supposedly quite a good ankle doctor. He said removing the fragment would leave a big hole and the chonro-gide was giving "pretty good" results. But now that the plug has been pulled on it and the surgery is scheduled for next week he is saying if he was me he would forget about the chondro-gide and have it cleaned out and do further procedures if it does not fix the problem.

 
Old 09-14-2012, 08:39 AM   #7
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Re: OCD microfracture surgery questions

Quote:
Originally Posted by draculr View Post
That sounds really bad

The surgeon I have is supposedly quite a good ankle doctor. He said removing the fragment would leave a big hole and the chonro-gide was giving "pretty good" results. But now that the plug has been pulled on it and the surgery is scheduled for next week he is saying if he was me he would forget about the chondro-gide and have it cleaned out and do further procedures if it does not fix the problem.
One of the three procedures I had was this one. My surgeon said it would be about an 85% chance that it would regenerate bone growth eithout yhe cadaver bone. I hope this is true. I havent given this too much thought as my other procedures were so much more invasive and painful. How many of you guys have had this fail. The thought of more surgery mskes me cringe. He said we should know 3 months after the surgery.

 
Old 09-16-2012, 07:10 AM   #8
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Re: OCD microfracture surgery questions

I really don't know what to do... should I do this MF or not?? Can I continue to live with the pain as I have it now or do these things get worse over time?

Last edited by draculr; 09-16-2012 at 07:25 AM.

 
Old 09-16-2012, 08:01 AM   #9
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Re: OCD microfracture surgery questions

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Originally Posted by draculr View Post
I really don't know what to do... should I do this MF or not?? Can I continue to live with the pain as I have it now or do these things get worse over time?
One thing for sure is it wont get better by itself. If the pain is bad enough you should go for it. II put my surgery off for over 5 yeats. It was bad for all those years but it hadnt gotten much worse. I knew when it was the right time and you will too. Dont wait too long friend thats all.

 
Old 10-03-2012, 02:32 AM   #10
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Re: OCD microfracture surgery questions

So I had my MF procedure 2 weeks ago. I just saw the doctor for a follow up. He said it is the biggest hole he has ever seen @ 2.0x1.5cm.

Two weeks out it is hurting much more to walk on than before the operation. Is this still due to the surgery or not? The doctor said I am still recovering from the procedure but I am really worried at the moment that doing this MF procedure was maybe a huge mistake? Can anyone who has done this procedure tell me if it gets better in a few more weeks, or is the pain I am feeling now when walking going to remain forever?

All I wanna do is freaking walk without pain!

 
Old 10-03-2012, 09:46 AM   #11
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Re: OCD microfracture surgery questions

2 weeks and you're already up walking? After my microfracture, I was 8 weeks of strict no weight bearing.

It's way too soon to tell if it is a success. My doctor said I could have pain (like before the surgery for up to a year). It's been 8 months since my microfracture and I do still have some pain (but nothing like before). I am able to do some light jogging, use the elliptical, and bike.

 
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Old 10-04-2012, 01:01 AM   #12
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Re: OCD microfracture surgery questions

8 weeks? That makes me feel a bit better about my current state.. thanks!

 
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