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Dr. Silverman Examines Andrew Bogut’s Microfracture Surgery

November 29, 2012

Golden State Warriors center Andrew Bogut underwent microfracture surgery this offseason, and although the team expected a quick recovery Bogut is still dealing with swelling in his injured ankle.

The Warriors originally said that Bogut underwent “minor arthroscopic surgery” in April, but Bogut said he had a more serious microfracture operation.

The team expected a short recovery time for Bogut, even believing he’d be healthy enough to play in the Summer Olympics.  After he missed the Olympics, the Warriors updated their timeline for his return a handful of times.  They thought he’d be ready for training camp, then the beginning of the season, and now they believe he’ll be able to play this weekend, but Bogut has expressed disappointment with his rehabilitation process.

“It’s frustrating,” said Bogut, who spoke to the media Tuesday after missing another practice. “People look at you and think, ‘Why are you still hurting? It’s just an ankle.’  You feel like you’re letting down the team, the fans and the organization.”

Bogut, who has had a slew of injuries during his NBA career, said he doesn’t want to come back until he’s fully healthy.

“I’m still a little ways off,” said Bogut.  “It’s an interesting rehab, because there’s no real timeline for it. I’ll be back when I’m ready to play at 100 percent.”

The Warriors backed off their April statement, which said Bogut underwent successful arthroscopic surgery to clean out lose particles and bone spurs.  Tuesday they confirmed Bogut had the microfracture operation.

In a successful microfracture operation, new bone and scar cartilage is created by introducing a new blood supply to the weakened area.  Doctors make multiple incisions in the bone beneath the cartilage, which allows new blood cells to reach the joint surfaces and form cartilage.

Recovery from microfracture surgery can take up to a year, but the Warriors say Bogut’s operation was a minor microfracture procedure.  They stand by their six-month timetable, but it’s been more than seven months since Bogut went under the knife, and his return date is still up in the air.

Bogut has been unable to practice, but he works on a stationary bike and elliptical machine to stay in shape.  He’s also done some light shooting, but he is still unable to run on his injured ankle.

Head coach Mark Jackson wants to have Bogut on the court, but doesn’t want to rush him back too quickly.

“I want him back when he’s healthy,” said Jackson. “We don’t want him on the floor until he’s 100 percent. You get uncomfortable and more frustrated when you try to rush it back.”

Dr. Silverman Comments

Microfracture surgery is performed to treat small isolated areas of cartilage and bone injury of a joint, most commonly in the knee, ankle, and elbow.  By creating a bleeding response, the body can heal through the development of new bone and scar cartilage.

In the ankle, microfracture surgery works about 85% of the time, but the success rate varies with age.  A recent study concluded that if the patient is over 25 years old or the ankle lesion is greater than 1.5 cm sq., microfracture surgery is more likely to have problems.

In Bogut’s case, the fact he has continued to swell and have pain indicates he likely falls into the 15% of patients who experience complications. I am very concerned when my patients continue to have pain 6 months after surgery, as that period gives you a good look at the recovery process.

Doctors also need to repair the lateral ligaments during microfracture ankle surgery.  If those ligaments weren’t fixed correctly, Bogut is more likely to experience problems.

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