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I have a full thickness fissure in the cartilage under my patella. What does this mean and what are my options?

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Voting closed: August 01, 2007, 05:59:15 PM


Author Topic: Full thickness fissure in cartilage under patella  (Read 16646 times)

Offline Matt38

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Full thickness fissure in cartilage under patella
« on: July 27, 2007, 05:59:15 PM »
Help. I have been diagd. with a full thickness fissure in the cartilage in my lateral patellar facet. What are my treatment options?
« Last Edit: July 27, 2007, 06:40:42 PM by Matt38 »

Offline Nettan

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Re: Full thickness fissure in cartilage under patella
« Reply #1 on: July 27, 2007, 08:10:47 PM »
Have you discussed this with your OS ? Or is this from a Mri result ?
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline Matt38

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Re: Full thickness fissure in cartilage under patella
« Reply #2 on: July 27, 2007, 10:44:53 PM »
Thank you for the reply. I am waiting for my OS to get back to me but I would like to be armed with as much info as possible. I got a report from the office that perf. the MRI because I have a friend that works there. What can you tell me about this type of injury?

Offline Nettan

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Re: Full thickness fissure in cartilage under patella
« Reply #3 on: July 27, 2007, 10:51:56 PM »
Sounds like you have some cartilage problems under your patella. A fissure is a crack that in your case probably breaks through the whole cartilage to the bottom. I am not sure if that is correct, just a guess out of the words.
I don't know what your OS wants to do..could be anything from smoothing the area to try to repair.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline Matt38

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Re: Full thickness fissure in cartilage under patella
« Reply #4 on: July 27, 2007, 10:57:21 PM »
Thanks again... The Radiologist who read the MRI suggested there is nothing that can be done but that came from him, not my OS. Until he FINALLY gets back to me, I am trying to do my homework...

Offline Nettan

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Re: Full thickness fissure in cartilage under patella
« Reply #5 on: July 27, 2007, 10:58:35 PM »
You have big problems with your knee ?
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline Matt38

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Re: Full thickness fissure in cartilage under patella
« Reply #6 on: July 27, 2007, 11:22:57 PM »
Yeah... when I exercize, it gives out or causes pain for days. I am only 41 and would like to be active forever!

Offline Nettan

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Re: Full thickness fissure in cartilage under patella
« Reply #7 on: July 28, 2007, 08:13:24 AM »
Well I am 41 too(but 17 officially LOL).
I also would like to be active forever and though I am in wheelchair I will never give up the hope of running again.
Have you tried any brace to unload, just a thought ?
Please let me know what your OS says. Good to learn something new at least.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline Matt38

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Re: Full thickness fissure in cartilage under patella
« Reply #8 on: July 28, 2007, 06:29:34 PM »
I will keep you posted...Modern medicine is a wonderful thing; they make advances every day. Never give up hope to run again!

Offline Nettan

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Re: Full thickness fissure in cartilage under patella
« Reply #9 on: July 28, 2007, 06:37:08 PM »
Well I have one totally destroyed knee and the other one waiting for surgery..and a spinal damage..but you never know..as long as there's hope there's life. ;D
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline terry42

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Re: Full thickness fissure in cartilage under patella
« Reply #10 on: July 31, 2007, 12:31:49 AM »
Matt:

Your situation sounds very similar to mine, right down to the MRI report. My report says:

"Focal full-thickness fissuring involving the lateral facet and apex of the patella, with subchondral degenerative changes in the lateral facet.  No discrete defect."

My orthopedist told me pretty much the same thing as your radiologist -- there is not much that can be done.  He wants to scope my knee, and "smooth out" the cartilage, and do whatever else needs to be done.  He was vague about "whatever else needs to be done".  From what I understand, even if this surgery gives relief, it generally only lasts for a few years and then the pain comes back.

I've basically gone from being very active in sports my entire life, to limiting my physical activity in the last year to just swimming and walking.  It is a hard pill to swallow.  I want to get with a patellar femoral specialist before I consider any surgery, but it is difficult to find someone with expertise in this area.

I'm curious about your symptoms, and how they compare to my knee pain.

Here are some of my symptoms (any pain I fell is in the front part of my knee cap)

* I have moderate pain if I sit in a chair, and do a single leg extension with no weight.
* I have pain climbing a ladder.
* I have pain if I try to run up stairs, or even walk upstairs quickly.  If I walk upstairs slowly, there is no pain.
* I can do a pain-free left-handed basketball lay-up (going off my good knee), but a right handed lay-up is painful.
* I cannot jump without pain.
* I can run very carefully, even full speed with no pain. But if I land a little bit wrong, I get a sharp pain in my knee.

What kind of symptoms do you have?

If you get a chance, let me know what your doctor says about your options.

Thanks,
Terry42

Offline Matt38

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Re: Full thickness fissure in cartilage under patella
« Reply #11 on: July 31, 2007, 03:55:42 AM »
Hi Terry,

I have pain pretty much anytime I put forward pressure on my knee. Especially going down stairs. Also, the joint feels like it is going to give way sometimes. I spoke with my OS and he does not want to touch it; he says anything he does will not work long term and will probably make it worse.

Offline Shewolf16

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Re: Full thickness fissure in cartilage under patella
« Reply #12 on: August 06, 2007, 04:48:48 PM »
Hey,

     I am in the same boat as you guys. I had surgery in April/2007 and my OS removed part of my medial meniscus and removed a large piece of my petella cartilage that snaped off. He smoothed it out as much as he could with out exposing any bone.
     The only problem now is that I am still in PT due to the fact that I still cannot go up or down stairs without a large amount of pain and the feeling that the knee is going to give out.  I even have developed Tendonitis in the knee due to over doing it in PT.  I can do a leg extention with no weights and the pain is AWFUL and people standing 4 feet away from me hear the crunching and grinding from my knee.  My OS said that will go away with time, I am not sure I believe that will happen. It has been almost 4 months and it has not gotten any better it has gotten worse. 
I am at the point where I don't know what to do any more. Any suggestions or help?

Offline terry42

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Re: Full thickness fissure in cartilage under patella
« Reply #13 on: August 07, 2007, 01:25:29 AM »
Shewolf:

I don't know what do do either.  I'm trying to find a patella femoral specialist, but I'm not having any success.  I keep hoping that if I can just find the right Doctor (or the right Physical therapist), he or she can help me out.  But unfortunately, at least on kneeGuru.com  I don't see a lot of success stories for people with patellar articular cartilage problems.

Does your OS have a theory about the source of your pain?  From your description, your articular cartilage is not worn through (so no underlying bone is exposed).  I was under the impression that exposed bone is what causes the pain.   I have had an MRI but I have NOT had arthroscopic surgery to confirm the MRI findings.  But my  MRI said "full thickness fissuring", so I assume this mean I have a crack in my cartilage with exposed bone, and the exposed bone is what is causing the pain.  In your case, if there is no exposed bone, what is causing the pain?

It seems that even when an orthopedist looks at a knee through an arthroscope, it is not always clear what is causing the knee pain.

Sorry, I don't have any answers.  Just a lot of questions.

Terry

Offline Matt38

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Re: Full thickness fissure in cartilage under patella
« Reply #14 on: August 07, 2007, 04:07:04 PM »
Hi,

I just heard of a therapy they are doing in Germany where they drill many micro holes in the patella which causes the cartilage to regrow. I dont know if this is snake oil or not. Anyone else hear about this?