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Hi Reflex, I also struggle with cartilage damage under my knee cap, but in my case it is probably more evenly distributed/spread out (hence, more difficult to fix with the above discussed procedures). You can read more about my story in the end of the following thread: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=67307.0Anyways, can I just ask you what type of hyaluronic injection you did? Synvisc One? Also, I'm not an expert in any way, but since your injury and surgery were quite recent I think (and hope) you can still make great progress naturally with time. I remember I read Dr Scott Dye saying that it is not unusual for a traumatized (injury and/or surgery) and inflamed knee to take many many months to calm down.I remember I took me a long long time to recover from my first injury and cartilage debridement/shaving, but I got back to pain free and almost normal function eventually. Then the knee broke down again many years later, but that is another story:) My knee also gets warm/hot/red almost every day, but I have noticed that it makes a surprisingly big difference if I ice the knee 20 min in the morning and 20 min in the evening. A 20 min icing at lunch helps the situation even more. Besides braces and stuff as tinydinosaur mentioned, maybe McConnell taping could be worth looking into? Haven't tried it myself, but I have understood it sometimes can help by pulling the knee cap away from an irritated area, calming down inflammation/irritation.Best,Brandon
Hi Aly0108,If the MRI in November 2016 didn't show any cartilage damage, at least you shouldn't have any serious damage I guess, which is good news! Be careful so you don't exercise too much, it is easy to push an already irritated knee over the edge with exercise. I have been forced to cut back on physical therapy several times, in order to get better. Lastly, I think the long recovery I had from surgery was simple because the OS didn't real fix the damaged cartilage, only kind of polished it. So after the surgery I had still damaged cartilage (although a bit more smooth/even surface) but now also the inflammation/irritation from the surgery that needed time to calm down. However, when the knee eventually had calmed down from surgery, it did feel much better than before, although not perfect. But as you say, in your case, I don't think there is any need for surgery (unless you have some other injury not mentioned here).
1. middle of the patella, i can't locate my surgery report with the specific size but i'll look around again2. yes several times (i think three in between surgeries leading up to the transplant, i had a LR, debridement, plication, MPFL, debridement previously). they've always just made my joint feel unpleasantly full, but i also didn't have a proper groove. from what my surgeon tells me some people get shots every 4-6 months and that's all they need. 3. it helped yes, it's hard to quantify. functionally / mechanically it restored the space between my patella and my femur. my surgeon showed me the x-rays pre and post and it's noticeable how much space it puts back in the joint. i gained more muscle back after the surgery but continued to have pain and dysfunction which eventually lead to a trochleoplasty, so with those two (and the MPFL) my knee is functionally sound, it has a groove to slide in and the transplant fixed the cartilage problem so my patella is no longer scraping grooves into my femur. to contrast my story, a guy also had the same surgery around the same time - 6 months post he was back to light sport, he was complaining that it wasn't as strong as he wanted yet and he felt like it was taking too long (meanwhile i was still having difficulty walking haha)4. it's a lot better than it was, though functionally i'm still really far from being independent because of all the past problems i had. ie. previously i could stand for 5-10 minutes before the pain was unbearable now i can usually stand for 30-45 minutes. i still have major muscle loss that i'm working to get back which i think also contributes to a lot of difficulty as it puts more stress on the joint. this combined with the trochleoplasty really changed the way my chronic pain is, i used to get severe pain that would start in the joint and kind of seize the whole leg up and the whole leg would ache and now a majority of the time that pain is just in my joint and my muscles stay 'healthy'. my muscles also respond really well to a heat pack now, whereas before they just weren't having it.edit: if i can answer any more questions for you i'll do my best. my decision to have surgery wasn't hard because there was no functionality of quality of life i was giving up. ie. they really couldn't make it any worse and i was getting no where with physio (8 years of it at that point)
1. middle of patella defects are tough to heal as I learned, due to the sheering forces2. I read a lot about injections and still not sure if they help - did you do stemcells?3. Good to hear that it did help... but it is a risky surgery with a long recovery time4. Quality of life is the final measurement... I feel an irritating pain the whole day, I have good days and bad days, and it it difficult to correlate them with PT or physical activity. Since the injury is 6 mths ago... I'm not sure if it does improve and I wonder what is causing it.