Focused more on the textbook in her lap than her volleyball teammates in front of her, FGCU junior Jessica Barnes was interrupted during a break in practice when one asked about her recent knee operation.
“I had microfracture surgery,” Barnes said to a blank stare from her teammate. “Not many people know about it.”
Until her doctor mentioned it this summer, the two-sport athlete had never heard of it, either.
But plagued by chronic, worsening pain in her left knee, she opted in August to become the first FGCU athlete to undergo knee microfracture surgery, the same procedure with the dubious reputation for failing top athletes.
Pioneered in the 1980s, microfracture can prolong careers and has been shown to have high success rates for patients under age 40. But it is often considered a last resort and as recently as last decade was still being called experimental and a “career death sentence.”
“It kind of scared me, just because I was looking at a lot of the statistics on it with the NBA players who get it done,” said Barnes, a star center fielder on the FGCU softball team and top reserve in volleyball.
“Some of them don’t return to the full capacity they were before. But I figured I’m young, and the doctor says the younger you are the better a candidate you are because the body can actually heal.”
Microfracture aims to regenerate a substitute cartilage in joints where the natural cartilage has been worn or sheered down to the bone, in athletes usually through a jarring-type injury.
Through a minimally invasive arthroscopic procedure, small holes are drilled or chipped into the exposed bone to reach the marrow. The stems cells released through bleeding help form a type of replacement cartilage.
“What will grow back is not quite the same as (natural) cartilage but a fiber cartilage that is the next best thing,” said Dr. James Guerra, a Naples orthopedic surgeon and the FGCU team physician.
“Microfracture is a legitimate procedure, and it works well on young athletes. It does not work well on patients over age 40.”
Because the other primary answer to damaged cartilage — a knee replacement — is not an option for athletes trying to prolong their careers, microfracture is sometimes deemed an athlete’s last resort.
“I really try to avoid it if I can. But sometimes there’s no choice,” Guerra said of microfracture, which he estimates he has done some 100 times in his dozen years of practice in Southwest Florida. “When a young athlete has a lesion there, there isn’t much you can do.”
Barnes, who earned all-Atlantic Sun Conference honors in softball last season, is missing volleyball this fall but hopes to return in the spring for softball. Her rehabilitation has varied from three to five days a week and includes routine thigh-strengthening and range-of-motion exercises.
“She’s a great kid to work with,” FGCU athletic trainer Mike Estes said of Barnes’ adherence to the strict rehab. “We plan on having her back on the field in the spring.”
Barnes consulted with FGCU coaches and staff and her parents before having microfracture surgery with Winter Haven orthopedist Larry Padgett, who performed surgery on Barnes’ thumb in high school.
Padgett, the Cleveland Indians and Atlanta Braves team physician, was not available to participate in this story.
“They were all for whatever I want to do. They said they would support me 100 percent,” Barnes said of FGCU coaches before adding that her parents’ support was the biggest influence on her decision.
“They knew that this was a problem for me. They were the people after practice and games I would tell how much pain I was in. They wanted me to feel better.”
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