Fibrocartilage

[Maverick]

What experience / knowledge does anyone have with fibro cartilage?

I had a Lateral femoral condyle (LFC) microfracture on my left knee back in September and I am still having challenges with pain.  The mfx was about 2 cm in size.  The area surrounding of the mfx has thin cartilage as a result of the prior injury.  I have pain off and one about 4 days a week, worse at night.  The pain is NOT surgical or tissue pain.

I know that fibrocartilage is thinner and rougher than normal cartilage so can this contribute to or be the issue for my continued pain?  If so, how?

I appreciate your feedback and thoughts!

[Maverick]

Does anyone have knowledge of fibro cartilage? 

[Adobec]

I don't have any answers but am interested in the topic.  I had micro two months ago and the pain concerns me.  If it continues, I will without a doubt opt for a partial knee replacement.  I can't even get through my day or play with my kids. 

[kneeproblems:(]

Fibrocartilage is a different type of cartilage to what is usually found on the surface of the bones in a healthy knee joint(hyaline cartilage). It is not as durable or robust in theory as hyaline cartilage however many people who have microfracture report good outcomes from the fibrocartilage produced.

Personally I had microfracture done on a defect on my medial femural condyle and the fibrocartilage produced was OK, liveable but not brilliant. In the end like all cartilage repair procedures it is not perfect and may fail fully despite the efforts of a surgeon and patient.

[Maverick]

Knee Problems, thank you for your insight.

[Vickster]

Bumping this thread rather than starting a new one if that's ok

No previous knee problems.  History, came off pushbike at speed in Sept 2009, tore lateral meniscus, 1.5cm2 defect on WB lateral femoral condyle, bone bruise.  Scope in Feb 2010, partial menisectomy, chondroplasty to Grade 3 on lateral patella, softening on lateral tibia, but most notably the LFC chondral defect had filled with fibro.   

Physio etc, didn't improve, tenderness, fresh MRI (showing damage to subchondral bone), referred to another surgeon for MACI (long, dull insurance related story).  Scoped in Dec 2010, but that surgeon deemed not suitable for the transplant due to kissing defects (extensive grade 1-2 on lateral tibia), defect still filled with fibro, tidied up, given Durolane injection.   He said I would need a DFO to align my knock knees before fixing anything else.  Things settle down, able to cycle etc, although always continues to be tender around that lateral side (presumably where the pesky defect is).

May 2012 start to have stiffness and soreness, especially on stairs.  Go back to the first OS and insurance agree to one course of 3 HA jabs...ouchy but seem to help - pretty much no pain other than cycling long or steep hills.  Discussion with OS, if doesn't help, he would like to try and fix the hole once and for all with an AMIC (insurance permitting blah blah).  He doesn't think my alignment warrants an osteotomy and would expect a cartilage repair to help.

So it's about 5 months since the last jab and that lateral side is rather tender and niggly, also even when low resistance cycling on exercise bike - I am off the roads right now having had tennis elbow surgery 3 weeks ago     I have pedalled 20km but can feel the knee more or less on every pedal stroke from start to finish (no change to bike set up)

I think my concern here is that the fibro has started to deteriorate - it's not an arthritic stiffness, more a burning around that lateral side at rest and walking.  When the OS spoke to me after the first scope, he said that fibro doesn't last forever but it is impossible to know how long it may last - I have had mine for 3 years how.  This hasn't been going on for too long (maybe a couple of months on the bike), so I've not contacted my OS - not like I could do surgery for some time as I could not use crutches!

I will confess to having gained some of my previously lost weight which I know won't be helping and due to the elbow, I am not able to exercise as I would like (trying to do 15-20k an evening on the exercise bike).  Weight loss is on the list   I will also have a chat with my PT when I start the elbow rehab tomorrow.

Has anyone had a natural fibro development or a successful mfx that has subsequently failed?  What did you go on to do if anything?

Be grateful for any insight or experience

[Maverick]

Vickster, nice to hear from you. Sorry about your continual knee challenges and your elbow.

I had a chondroplasty 3 weeks to address my pain issues. My OS found a cartilage flap which he trimmed. He said that this was not  the cause of my pain though. Currently I am being evaluated for CRPS.

Anyway, my fibro cartilage looked great with no issues. I am not allowed to run though probably to ensure my fibro cartilage stays in good shape. This is strange to me as my fibro cartilage is in a non-weight bearing area.

I hope that my experience helps.

[Vickster]

Thanks for your reply, Maverick. 

I haven't run on the knee, not an issue as I never did run other than for a bus!  I can't kneel on it either - apparently the defect is slap bang on WB, or where it would touch the ground kneeling

This is my MRI from Oct 2010 - the jaggedy bits in the bone aren't a great feature 



I am going to try to lose a few kgs (probably now in the new year with a holiday and Christmas coming up  ), use the exercise bike, see if my PT has any suggestions.  Muscles are tight as anything, need to stretch (unfortunately, I struggle with some as my operated elbow is on the same side as the offending knee and need the arm to hold, support etc)


I hope you get your knee woes sorted out soon