Felice Herrig has been out of MMA action for nearly two years, but it was recently announced that she will return to fight in August, at UFC 252. She last fought, and lost to Michelle Waterson in October 2018. Since then, she has been battling back from a knee injury and a couple of surgeries.

Herrig underwent ACL and meniscus reconstruction in her right knee one year ago this month. In a recent Instagram post, she gave some details of the problems she was having, leading up to the surgery. She references having a microfracture procedure that seemingly caused more problems that it fixed.

"The area I had micro-fracture done gave me so much pain & inhibited my movements. I had a hard time doing some of the exercises I needed to do to get better."

During her rehabilitation from that procedure, she developed bone contusions and edema at the site of the microfracture, causing pain and inability to fully participate in her rehab program.

The questions that come to mind are these: was her ACL torn at the time of her microfracture surgery? Did she have the ACL repair and microfracture surgery done at the same time? Or, did the ACL injury occur subsequent to the microfracture? If the answer to the last question is yes, that means that her rehab after the microfracture did not go well (as she alludes to on the Instragram post), and she likely tore the ACL as she was rehabilitating! These would be good questions for someone to ask her in an interview. (Please, someone with access- ask these questions!)

Microfracture surgery is an arthroscopic technique used to treat areas of full thickness damage to the articular cartilage. The surgeon cleans out the area of damaged articular cartilage. This leaves bone tissue exposed. Multiple small holes, or microfractures, are drilled into this area of bone (see below), using a pick-like tool. Blood from these holes forms a large clot at the surgical area, and this clot is the foundation for the development of fibrocartilage tissue to repair the defect.

Arthroscopic image of microfracture holes.

Recovery from this surgery is slow, because it can take up to 6 months for the maturation process of the new tissue to occur. The athlete may be restricted from weight bearing on the leg for up to 8 weeks. This can present a problem, if the athlete tries to push past the restrictions and accelerate the rehab process. The long-term success of microfracture surgery in high impact endeavors such as MMA is largely unknown. I believe that the articular cartilage lesion that she must have had that resulted in the microfracture surgery could me more problematic for her in the near term. These types of lesions don't just heal back to normal on their own, and it seems obvious that the surgery done in an effort repair this damage failed. But on a postive note, since having the ACL surgery a year ago, Felice seems to have turned a corner and is fully recovered.

It is good to be back in the BE community! Please comment, and give me a follow on Twitter, @MMAInjury.