TK, you definitely make me earn my keep around here.
Microfracture patients are most reliably followed by their clinical progression as relates to pain and swelling at each phase, as well as range of motion and strength improvement over time. Once the patient begins weight bearing, in determination as to whether they are appropriate to advance to the next activity level.........walking, jogging, jumping, etc., he will be monitored for
maintenance of normal mechanics.
MRIs are more an adjunct testing to follow progress anatomically, but definitely takes a back seat to the clinical evaluations. After the microfracture procedure MRIs are commonly evaluated preoperatively and 6, 18 and 36 months after surgery, although this is ultimately at the discretion of the surgeon. The MRI becomes more important in the cases where clinical problems come up. Studies in even non athletes have shown that the anatomical improvement may occur over the 1st 18 months but wear-down deterioration occurs universally after that.
It is so important to understand that no matter what microfracture or resurfacing technique is used,
several studies have shown that they may have a measure of success only if the biomechanical properties affecting the joint with tibiofemoral or patella malalignment and ligament instabilities are considered and treated as well. Clowney's potential for ongoing aberrant mechanics due to hip and foot pathology remains a great concern to me, not only in the short term but especially in his longer term prognosis.