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Author Topic: Trochlear groove, micro fracture, lunge lesion  (Read 171 times)

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Offline JohnsonSNCC

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Trochlear groove, micro fracture, lunge lesion
« on: February 08, 2018, 09:40:03 PM »
Hi folks. Came across this in a last ditch attempt to get some help. Developed a knee problem about a year ago after an intense road bike session. Went through a few diagnostics until a saw a surgeon who said Iíd got the above, different terms. He said he wouldnít operate and Iíd have to make due with this. As you can image I was devastated as I couldnít do any running, jumping or my love of life cycling. Having 5 months off I finally made it back on the bike for about 4 months and all going well  cold weather impacted on. Iíve made a few attempts over last couple of months without success. I was hoping people had advise, recommend surgeons, best ways to deal with it, does surgery work and such. Iím looking for for hope at the moment so I can get back on with my job ( PE teacher) properly and get back to riding miles a week and my sportives. Please help. Live in Derbyshire

Online Vickster

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Re: Trochlear groove, micro fracture, lunge lesion
« Reply #1 on: February 08, 2018, 10:12:24 PM »
Who recommended microfracture, which is a procedure to try to repair cartilage damage was it the surgeon, but he wonít do it?
Have you had an MRI scan?
Are you prepared to pay for surgery privately assuming you donít have private health insurance? Keyhole probably around £4K plus any rehab. If you want a more advance repair, £10-15k wouldnít be unusual and there are no guarantees. Probably a year or two to rehab to current levels and hopefully beyond!

Not heard of a lunge lesion before...info here

Lunge Lesions

The "lunge lesion" is an isolated injury to the femoral articular cartilage in the groove (Trochlea) through which the patella runs during knee flexion. It is the result of high shear and compressive forces produced by deceleration of the flexed knee, with co-contraction of the hamstrings and quadriceps muscle groups. Classically during a lunging motion as often occurs in sports such as squash, tennis, and netball. This roughened articulating area produces a painful, grinding sensation as the flexes leading to joint irritation and swelling. In severe cases this damaged area requires an arthroscopic chondroplasty to smooth the roughened articular cartilage. All patients however will require an exercise programme of Quadriceps strengthening and Hamstring stretching to protect against further injury.

Assuming you mean you have a cartilage defect in the groove, irs a very tough area to fix especially if your kneecap doesnít track properly (usually the cause of trochlear damage). Any repair could well just wear away again and especially with the repetitive motion of Cycling. Is the worn area full depth through to the bone? This could be why the surgeon is not prepared to operate, low chance of success and you could end up worse off.

If I were you, Iíd find a sports Physio with a special interest in knee injuries and Cycling. Get your muscle balance assessed and see what you can do to get everything working as it should and the knee tracking right especially on the bike

Google and the phone will be your friend

This clinic looks promising as a stating point
http://www.thesportingjoint.com/about-us/

Some good info in the various relevant primers, patella, joint cartilage etc

http://www.kneeguru.co.uk/KNEEnotes/learning-portfolio

http://www.kneeguru.co.uk/KNEEnotes/learning-portfolio

Info here about cartilage repair, at the bottom a paragraph about return to sport
http://www.kneeclinic.info/problems_articular_cartilage.php

The groove isnít weight bearing but the shearing forces make defects hard to patch up successfully

Good luck
« Last Edit: February 08, 2018, 10:39:20 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
LK New MRI shows lat & medial meniscus tear & other stuff
RK MRI lat meniscus tear
8/1/15 RK Steroid jab,
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation

Offline JohnsonSNCC

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Re: Trochlear groove, micro fracture, lunge lesion
« Reply #2 on: February 08, 2018, 11:12:13 PM »
Thatís funny as sportingjoint is my physio place now haha. Iíve emailed doctor Geutjens PA for more info. Just want second opinion. Valverde smashed up his knee and joint and had his op, recovered and now back to winning in the time Iíve still got no closer to it being even attempted at being done😡. Thanks for the insight! Just unbelievably fed up with everything now!

Online Vickster

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Re: Trochlear groove, micro fracture, lunge lesion
« Reply #3 on: February 08, 2018, 11:17:57 PM »
Whoís Dr Geutjens? I cycle but no interest in pro cycling myself

You didnít mention that youíre having Physio. What have they said?

If you want a second opinion from a surgeon privately in the Midlands, Tim Spalding has a stellar rep. Heís in Coventry. A surgeon wonít operate even privately if they think thereís a low chance of success

If you want to travel further, Dr Shetty in Kent is doing some interesting stuff repairing articular cartilage in the patellofemoral joint

Think both have details in the specialist database linked at the top
« Last Edit: February 08, 2018, 11:21:13 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
LK New MRI shows lat & medial meniscus tear & other stuff
RK MRI lat meniscus tear
8/1/15 RK Steroid jab,
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation















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