KNEEtalk

The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: Lottiefox on November 29, 2009, 03:54:02 PM

Title: Hi all, new member and some questions on OCD
Post by: Lottiefox on November 29, 2009, 03:54:02 PM
Hi everyone, firstly I want to say what a great source of information this site is. I thought I'd take the plunge and post after a few weeks of knee issues and having recently got my MRI reports back.

I'm a fit and active 40 year old, used to enjoy training 4-5 times a week and whilst I've always had somewhat "creaky" knees I've always found they responded well to a bit of rest and ice and gentler treatment if needed. My problems started more seriously in the summer with the gradual onset of sharp pains on lunge activity and then a really bad pain that set in after an especially hard day long training session in a park doing loads of shuttle sprints, jumps etc etc. The pain was left knee, medial, and quite localisable. Anyway, without boring anyone with longer details things have got worse since then, with pain on impact activity and now a stiff and sore joint that won't pivot properly, feels unsteady and is swollen over the kneecap and on the fat pad. I've cut out all lower body work for about 4 weeks now (going slowly mad!!!) but the pain remains and even walking (I did 15 mins of Xmas shopping yesterday with constant sharp pains and weakness) is getting harder. Stairs are tricky and I'm taking them sideways, and anything slippy like a swimming pool edge fills me with fear! I can't squat down without pain, and can't drive a manual car or do a proper extension of my leg without it being on a surface to take the weight.

I was referred through my usual Sports Physio for an MRI and the results indicate this:

No major meniscal or ligamentous abnormality is seen
There is an area of minor osteochondritis dissecans in relation to the inferior aspect of the medial femoral condyle with some surrounding oedema but there are no features to suggest this is unstable.
There is some early patellofemoral OA change with chondral thinning irregularity and sunchondral oedema and some moderate oedema to the infrapatellar fat pad.

I've been on Naproxen for a week now since having the scan (just through my GP who prescribed without the report) and the swelling is going down, the kneecap pain is definitely reduced but the sharp medial pain remains. I've done some reading on OCD and its scared me witless! I'm due to see Glyn Evans at the London Knee Clinic in a couple of weeks (recommendation of a colleague who had knee surgery there) but until then I wondered if anyone could offer advice on what this might all mean especially the OCD part.

Thanks in advance for any words of wisdom!

Lottie  :D
Title: Re: Hi all, new member and some questions on OCD
Post by: derek320 on November 29, 2009, 05:37:44 PM
OCD is a tricky injury, it can come in 4 stages, during Stage 1 and 2, the lesion is stable for the most part. During stage 3, the lesion begins to break away from the rest of the bone and during stage 4 the lesion has broken completely free and is floating around the knee.

It sounds as though you have OCD in stage 1 or 2, at this point, they may want to try a conservative method such as bracing the knee and having you non-weight bearing for a few weeks, this may allow the bone lesion to reattach itself. You are lucky that they caught the OCD while the lesion is stable, they have more conservative options than an unstable lesion.

For me, the MRI caught my OCD at stage 3, the bone lesion was beginning to break loose, my surgeon decided that the best option was to use screws to secure the lesion back in place. However, within 2 months of that appointment the OCD lesion had developed to stage 4 and was free floating within my knee, so my surgeon went into my knee thinking he could screw it back in place and ended up having to remove the lesion and performed a microfracture surgery. So you are pretty lucky that they caught your OCD very early on so that you don' t have to go through the same thing that I did.

As for the swelling, that is expected. My knee began bothering me a lot in May-June 2009 and swellled up a lot. I went into surgery in August 2009 with a swollen knee and my knee is still swollen now almost 4 months post-op. I met with my surgeon on Friday and he said that is was normal, he said that injuries like mine that involve bone and cartilage damage usually come with a lot of swelling that takes a long time to get rid of. He told me that there will probably always be a little extra fluid in my left knee than in my right knee due to the type of injury and the type of surgery.

I hope this helps with any questions you have about OCD, I have a thread on my OCD story that I still update occasionally if you want to check it out.

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=48081.0
Title: Re: Hi all, new member and some questions on OCD
Post by: Lottiefox on November 29, 2009, 07:00:21 PM
Derek, thanks for taking the time to reply. I've read your post a few days back and I'm glad you're doing well now - plus coping with having your appendix out - not great timing for two surgeries!

Indeed, I kind of think its good they have found something they describe as "stable" - I am sort of thinking that I might be non weight bearing for a while whatever happens! I'm keen to avoid surgery if it can be helped conservatively. I assume they then re-scan to see if there has been an improvement? I'm also going to avoid anything in the future that involves running around a park being shouted at by a stern man in army combats!

Good luck with your continued recovery  :D