Ironman following microfracture knee surgery?

author : AMSSM

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A physician specialists addresses the questions of whether a triathlete complete an Ironman four months after microfracture knee surgery

Member Question by BigTriGuy

"I had microfracture knee surgery in February. Healing was very slow, and only since I've started taking Diclofenac have I been able to walk without assistance (cane). I am in physiotherapy and pool therapy. I am swimming and just started biking. My concerns are:

1. My good knee is starting to feel pain and I had difficulties standing out of the saddle during my first first ride.
       
2. I plan on taking things very slowly but I'm concerned that I might do serious damage to the knee through training or on race day.

I have four months before my Ironman race, am I pushing things? Thanks for your help."

Answer by Luis D. Salazar, MD

After a procedure like Microfracture surgery, followed by a period of non-weight bearing, both legs could have muscular atrophy and weakness.

Depending on the location of the microfracture procedure, it can take 4-6 weeks of non-weight bearing movement, followed by a period of weaning from crutches for recovery.

Normal return to full activity and sports clearance can be 4-6 months after surgery depending on healing and physical therapy progression. Most clinicians will use the lack of pain, inflammation, swelling, or feeling of knee instability with sport/activity as an indication to return to sport.

Functional testing can be done to measure and assure symmetrical strength and ability as part of guiding returning back to activity. It is not unusual that during the recovery process the non-injured extremity take the brunt of stress and is over-used. This can begin to cause discomfort or pain with activity.

If the pain persists, or you are having pain with normal daily activities, swelling, catching, locking, or sensation of the knee going out, an evaluation of the knee may be necessary.

It is hard to know if you will be fully recovered in time to participate in your Ironman race, but if you have any concerns you may consider a re-evaluation by your orthopedist.

Luis D. Salazar, MD
Primary Care Sports Medicine
The Ohio State University Sports Medicine Center

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date: September 16, 2011