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Author Topic: Grade 3 chondromalacia of patella  (Read 12267 times)

Offline fyrecatt2001

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Grade 3 chondromalacia of patella
« on: May 15, 2004, 02:47:41 AM »
I am a 26 yr old woman.  I have had mild pain and crackling in my knees since high school, but nothing I've ever seen an MD about.  Approx. 6 mo ago, my large dog ran headfirst into my RT knee.  Since then I have had pain that has progressively gotten worse.  I got the results of my MRI today and was dx w/ grade 3 chondromalacia of the patella, a small osteophyte, and a small amount of effusion.  The ligaments were all intact and there were no pieces of bone or cartilage loose in the joint.  My PCP is having me try a week on crutches, elevation, and anti-inflamatories to see if we can get the pain to reduce before referring me to an orthopedist.  Has anybody been in a similar situation?  Is there anyway to treat this, or am I destined to just live with the pain for the rest of my life?  I don't look forward to the prospect of having arthritis in my knees before I'm middle aged, but the stuff that I've read on the web doesn't look promising.

Any thoughts would be greatly appreciated.

Renee
Rt Knee - Grade III chodromalacia patella
Arthroscopy w/ chondroplasty 06/23/04

Offline Natalie.D

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Re:  Grade 3 chondromalacia of patella
« Reply #1 on: May 17, 2004, 01:30:50 PM »
Renee,

I have grade II chondro, so not as bad as you but still pretty painful at times.  I've unfortunately been told that there is nothing that can be done for me and I'll just have to live with it and keep taking the anti-inflamatories - not what I wanted to hear.  Have you tried applying heat - it really works for me, obviously its only a temporary relief but I have gotten myself an electric heat pad and sit with it on every night and it does help ease the pain.  Sorry I can't be of any help, I'm still looking for a solution too so if you get any info please post it here.

Natalie.
Dislocations since age 12
Trochlear Dysplasia
Maltracking
Hypermobile
LR/MR-failed
TTT, LR, MR L knee 95-Success
TTT, LR, MR R 02-Success
Screws out
Partial tear ACL
Severe end stage OA
4 Debridements
Partial Meniscectomy
Failed Microfracture
11mm Defect LFC
Bone Spurs, Kissing Lesions

Offline nradclif

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Re:  Grade 3 chondromalacia of patella
« Reply #2 on: May 17, 2004, 08:46:22 PM »
renee,

how do they know it is grade 3?  have you had any arthroscopic surgeries for the OS to take a look.  i certainly wouldn't just take this lying down (literally).  i would try several concervative approaches, i.e. glucosamine, PT (you have to build up the muscle), petella straps, bextra or celebrex, acupuncture, etc.  if none of these work, and make sure you give them proper time to work, then i would have a surgery to at least let an OS actually see what is going on in your knee.  i would never take 'nothing we can do' for an answer.  there are plenty of OS out there that will be willing to try to aleviate your pain.   i would say to make sure that your OS is in sports medicine, they seem to know a lot more alternative treatments and surgeries styles than the others do.  

i myself have tried all the concervative approaches other than acupunture, which my cousin swears by, and all of them had some positive effect, but not enough to make me totally happy.  now i am debating on wheter or not to have surgery in the fall or soon after.  there are all kinds of good things happening out there in cartilage research, so i suggest do whatever necessary to stay active until they find the "cure" for this.  

take care,

nate

Offline 2soreknees

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Re:  Grade 3 chondromalacia of patella
« Reply #3 on: May 18, 2004, 03:35:35 AM »
Renee

I have grade IV chondro in my right knee.  I had arthro and he treated it with microfractures which helped for a couple of years...

it is a pain (literally) especially when it rains or I overdo my activities.  But you are young and perhaps the glucosiamine/chondroitin would really help you.

I agree that the use of heat can really help this particular knee malady(I soak in a hot bath with lavender)  however I find heat makes my other knee get worse...but that is my problem to deal with.

I am surprised that your doctor was able to diagnose so much with just an MRI...they gave you some good advice though - antiinflams, elevation will help.

I hope your pain decreases and that you get referred to an OS soon.

Keep us posted!
Tery
2/02 (R)arthro. meniscus tear, microfractures, grade 4 chondro. under patella.
TTT/LR on (L) 3/03. 
11/04 Arthro (R) MF
4/06 (L) clean up and trim back scar tissue from LR
11/06 (R) HTO
8/08 (R) Hardware removalMFR
8/09 L microfactures
12/09 LTKR
11/11 R TKR and last knee surgery!

Offline Hglick

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Re:  Grade 3 chondromalacia of patella
« Reply #4 on: May 18, 2004, 04:17:44 AM »
I have a tracking problem or chondromalacia, depends on who you ask.  My PT said tracking problem, but my chiropractor thinks it's chondromalacia.

Some things that have helped the pain:

Ice
Moist heat
Massaging around the knee
Electrical stimulation - tens unit
exercise - I go to the gym every other day to help my knees (before, I never exercised) - my left knee was not as bad and actually is now pain free  (I started out doing straight leg raises and stretching exercises.  Now I use an elliptical machine (no incline) and used adductor/abductor weight machines and leg press at gym, but I avoid the leg curl and leg extension machines.  I also do step ups and step downs.  You can search for exercises or the internet.  I will try to post some on here later, or you can probably find some on this site.  
Taping my knee (did it on my own - physical therapist never did it for me nor showed me how - I learned from internet website) - McConnell method.  
Ibuprofren - always take with something in your stomach.  
Relaxation - stress seems to make my pain worse
New shoes - Buy a good pair with ample cushioning
I take glucosamine/chondroiton, ester-c, and cod lievr oil supplements
I also use blu emu ointment
Also, I have lost about 12 pounds since I started having knee problems.  I don't think weight always causes problems, but I don't think it helps either.  I am NOT suggesting you are overweight, just that weight loss can be helpful for some people.  

The blue emu and the vitamins have not noticeably helped the pain, but maybe they are helping at a cellular level.  I figure they can't hurt me.


By the way, I am also 26, and my pain seemed to come on suddenly, but I've been told I probably had some problem (mal-alignment) for years, but only now showing up.  For years, my right leg has been larger than left.  I thought it had more fat cells or something:)  Anyway, from what I gather, it was probably because my my inner thigh muscles are weaker than my outer thigh muscles (according to my PT).  This could also be due to back alignment problems I have had.  


Don't listen to everything the doctor's say/or every test result.  I agree with the person who said to look into exploratory surgery.  I may be heading in that direction myself.  

At first I went to my general practitioner, who ordered x-rays, and according to the radiologist, there were "osteoathritic" changes of my knee.  They told me to go home and take some ibuprofren.  At this point, I couldn't drive to and from work because of the pain!!  Thank God I was able to switch onto my husband's insurance a month later, and I was able to go to an orthopedic surgeon.  He ordered MRIs of both knees, which showed no articular cartilage damage or chondromalacia or other damage, other than slight effusion, or swelling, of my right knee.  He sent me to physial therapy.  It has not cured my pain.  However, it has definitely helped.  I can drive, and with less pain.  Sitting at work is still uncomfortable though.  If I had gone home and listened to first doctor, I can guarantee you I would be in more pain and much worse off.


The other thing that helped me was going to a chiropractor, who discovered my one leg was shorter due to back alignment problems.  My bad leg was an inch and a half shorter.  He does electrical stimulation and heat therapy on my knee, which feels great and takes away pain temorarily.  Also, recently he has prescribed orthotics.  He says he thinks I may have chondromalacia even though MRI said no chondromalacia because I had an MRI without dye.  Which makes me ask you, since your MRI supposedly detected (I'm not questioning you; I just know that tests are never 100% accurate) chondromalacia, did you have an MRI with dye?  I think my chiropractor means well, but let's face it; he is not an orthopedic surgeon.

Also, another example, I have a friend whose daughter had continual pain and clean MRIs.  It turned out she had a plica (as discovered by exploratory surgery).  I suggested that to my orthopedic surgeon, who told me that an MRI would pick that up (which is not true).  This is why the next time I go to a surgeon, it will not be him.  

I thank the knee guru site and others out there for educating me about knee probs.  You have to keep up on stuff because you're your best advocate.  You have to almost know, sad to say, when a doctor is incorrect.  There are good doctors out there, but unfortunately sometimes we have to weed through the bad ones.  I picked my first doctor at random from an insurance book.  The surgeon I really want to see is not on my insurance plan and not in my price range.  My chiropractor did recommend someone though who is on my plan, so I will try going to him next.

Anyway, I am going to give my orthotics a few months and then I will probably head back to a surgeon for exploratory surgery if symptoms don't improve.

I hope you gain some relied from the pain.

Above all, there is aways hope.  That is what my chiropractor always tells me.  I have had really bad days when I am very depressed, but then the next day could be super.  To be honest, the worst days I have, are usually when I think to much about will I ever get better.  When I worry less, the pain seems to not be as bad.  You have to take care of yourself, but at the same time, you can't let the knee probs consume you.  

Offline Hglick

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Re:  Grade 3 chondromalacia of patella
« Reply #5 on: May 18, 2004, 08:24:24 PM »
Here is a link to some exercises

http://www.nismat.org/ptcor/pfp/

I did straight leg raises without ankle weights at first and then progressed to 2 lb ankle weights.


Offline Linds

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Re:  Grade 3 chondromalacia of patella
« Reply #6 on: May 18, 2004, 08:46:42 PM »
Chondromalacia as the other's have said is not just something you can take a pill for and it will go away, but there are ways of managing it best you can as ther others have said.  I know how you feel, I am 23 and I have grade 2 possibly worse by now Chondro in both knees and it isn't any fun and looking towards the future isn't much fun either. Keep reading and asking questions, information is the best allie.

Hglick- Chondromalacia can go hand in hand with maltracking as the maltracking can cause cartilage to soften.

Goodluck Renee,
Hugs Linds
PS why did you choose Fyrecatt as your name, my horses name is Firecat :D
1997 Scope RK
2002 LR RK
2002 Scope and hematoma evac RK
2004 LR LK
May 06 Fall from Horse, partial ACL tear and meniscus injury, Tibial plateau injury
2007 Scope, Plica Excision and Debride LK
2009/2010- Possibly Ankylosing Spondylitis?

Offline fyrecatt2001

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Re:  Grade 3 chondromalacia of patella
« Reply #7 on: May 20, 2004, 06:09:42 AM »
I have almost finished my week on crutches (one of the most sadistic devices ever invented) and anti-inflammatories.  I have also been wearing a knee brace that is supposed to have patellar support - it seems to help somewhat.  So far the general discomfort that I have doesn't seem to have improved that much and I don't know about the pain that I have when bearing weight since I haven't since I started on crutches.  However, I have noticed something odd - when I take my brace off my injured knee looks slightly smaller than my non-injured one.  I don't know if that is just from the compression of the brace or if I have had some swelling in both my knees that I never really noticed b/c they both looked the same.  Before my injury, both of my knees crackled and would ache when the weather changed. I would also have occasional sharp pain when moving from certain positions.  

The MRI that I had was without contrast.  I haven't seen the films so I don't know how the radiologist knows it's grade III.  Maybe he can see the shreds of it hanging off the patella or something.  I am thinking that the crutches and inflammatories may help some, but they won't fix the problem.  I will most likely ask my PCP to refer me to an OS to get a more experienced opinion.

Thanks to everybody for your help and suggestions.  When I tell the people at work why I'm on crutches everybody makes a horrible face - not very comforting considering that I work at a hospital.  The few other people at work that have had knee problems didn't have very upbeat stories.  Anyway, I will keep you all posted and share anything I learn.

BTW - I chose Fyrecatt because one of my favoritie poems is William Blake's "The Tyger".  The first line begins "Tyger, Tyger, burning bright, in the forests of the night..."  In a sort of roundabout fashion: Tyger burning bright = Fyrecatt.
Rt Knee - Grade III chodromalacia patella
Arthroscopy w/ chondroplasty 06/23/04

Offline gr8fit

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Re:  Grade 3 chondromalacia of patella
« Reply #8 on: May 20, 2004, 07:13:58 AM »
Hi,

I have chondromalacia patella.  I was told two years ago that I have a knee joint of a 75 year old woman with arthritis (I'm 40  and I used to run 45 miles a week..among a lot of other activities).  I'm still very active, it's just the quality of movement is not there and I need to warm up a lot before I do anything.

The OS was totally "taken back" after he did the knee scope on me two years ago.  He just thought I had a lateral meniscus tear...boy he was he suprised.

I was never told what "grade" I have...I'll have to ask about that!  It's painful.  Staying active helps.  But my knee most certainly dictates what I can or can't do on any given day.  

Try to stay positive....hopefully it helps knowing that others have a very similiar problem.

Best Always.


3/22/02: RKScope.Grade 4 Chondromalacia patella Microfracture.
09 & 11: L ankle Scope
9/17/09: RKScope.
11/5/09: LKScope.
2/24/10: Bilateral PFJR
12/13: L-spine Laminotomy
3/31/14: RTKR
5/28/14: LTKR
7/23/14: LTHR
pending RTHR

Offline Leentje

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Re:  Grade 3 chondromalacia of patella
« Reply #9 on: May 20, 2004, 05:22:20 PM »
I too have chondromalacia. Grade III in left knee, Grade I in R knee (as seen on CT/MRI). Everyone who looks at my scope pics from my LR, CTresults and arthrogram, was amazed that i was still able to walk around :o! You should see their looks when I tell them I still play badminton :o ::) :P Oh well, it's painfull but managable. And it won't "just go away". Not anymore.

There's no cure but you can do things to ease the pain, such as braces exercises and stuff. Do some reading and I'm sure you'll find al labout it!

~Helena
Bilat patellar malalignment/PFdysplasia
00/06/83 L wrist #
11/12/00 L knee LR + chondroplasty
21/08/02 L knee TTT
02/03/04 L knee stretched PCL
11/09/07 L ankle dislocation/medial avulsion #
25/05/09 L ankle medial avulsion # AGAIN!
05/06/13 R ankle dislocation

Offline fyrecatt2001

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Re:  Grade 3 chondromalacia of patella
« Reply #10 on: May 21, 2004, 02:25:44 AM »
I got a chance to look at my MRI films today and I can definitely see the cartilage that the radiologist talked about.  I have my first appointment with an OS tomorrow.  I let you know how it goes.

Renee
Rt Knee - Grade III chodromalacia patella
Arthroscopy w/ chondroplasty 06/23/04

Offline fyrecatt2001

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Re:  Grade 3 chondromalacia of patella
« Reply #11 on: May 22, 2004, 07:39:31 AM »
Well, I saw my OS for the first time today.  He agrees that I have chondromalacia, but he thinks I might have some other problems going on too.  He did some other tests that involved wiggling my knee around alot and said that he thinks my ACL could be torn.  He is also concerned that I might have a medial meniscus tear b/c my knee tender to the touch on the medial side.  He has scheduled me for an arthoscopy in one month to shave the cartilage of my patella and check out my meniscus and ACL.  All in all, I am happy with the decision b/c if the chondromalacia is causing the pain then the surgery should help it and if the pain is from another reason, we will be able to find out what that reason is.  I am a bit nervous about having surgery and am going to have to do some research to see what I'm going to be going through.  Thanks again for your support everyone.

Renee
Rt Knee - Grade III chodromalacia patella
Arthroscopy w/ chondroplasty 06/23/04

 















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