The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: snett on October 06, 2011, 11:18:04 PM

Title: help with results of my MRi
Post by: snett on October 06, 2011, 11:18:04 PM
Im not sure what to take out of this finding and what to expect, i have a very sharp pain on the inside of the rt kneee just to the left of the petella when i walk or put much weight on the knee.

Im supposed to see my os in the next few days, but am wanting an explanation of what they have found with the mri.




 EXAMINATION:  MRI of the right knee 10/04/2011.

 HISTORY:  Pain.

 COMPARISON:  Plain radiographs right knee from 09/27/2011.

 TECHNIQUE:  Sagittal, coronal and axial proton-density fat-saturated,
 sagittal T1-weighted, sagittal oblique T2-weighted fat-saturated
 images were obtained through the right knee.


 Ligaments and tendons:  ACL and PCL are intact.  The extensor
 mechanism is intact.  The MCL, iliotibial band, biceps femoris tendon
 and fibular collateral ligaments are intact.

 Menisci:  There is no discrete tear of the lateral meniscus.  There is
 no discrete tear of the medial meniscus.

 Bones and cartilage:  There is no focal chondral defect of the lateral
 compartment cartilage.  There is high-grade fissuring mid
 weightbearing medial femoral condyle cartilage with prominent
 underlying edema seen on image 11 of series 301.

 There is no focal chondral defect of the patellofemoral compartment

 Soft tissues:  There is no significant joint effusion.  There is
 minimal prepatellar edema.


 Focal area of high-grade fissuring mid weightbearing medial femoral
 condyle cartilage with underlying prominent subchondral edema.

Title: Re: help with results of my MRi
Post by: vickster on October 07, 2011, 08:18:33 AM
I am no expert but on the whole, the knee joint is in tact other than
Focal area of high-grade fissuring mid weightbearing medial femoral
condyle cartilage with underlying prominent subchondral edema.

Which means you have some damage to the articular cartilage (the shiny stuff on the bones) in one spot on the medial (inside) bit of the bottom of the thigh bone (condyle) with bone bruising - see what the surgeon suggests - have you had an injury to the knee or has this developed over time (how old are you)? 

It may be that a tidy up might be in order or letting the bone bruise settle - these can take 12 months to go - I had a big one and it was very painful, went in around 6 months.  Cartilage damage doesn't heal per se as there is no blood supply - however, with ice, drugs and strong muscles around the knee it can be managed.  It's not that easy to fix either

Have a read of the anatomy and arthritis sections in the Information hub

Good luck :)
Title: Re: help with results of my MRi
Post by: snett on October 07, 2011, 05:13:39 PM
im 39 and im not sure what would have caused it, i had a PCL injury about 4 yrs ago and with intense rehab it came back very strong, this one im not sure , but it has been very painful to deal with, im hoping the OS has an idea of what to do with it.

Thanks for your reply

Title: Re: help with results of my MRi
Post by: dm on October 07, 2011, 06:50:50 PM
sounds like you've tore a hole in the articular cartilage, the rubbery stuff that covers the bone end on the inside knob at the end of your thighbone. If it's got some loose and rubbing around then that could be what's causing the pain. Doc may say you need it scoped to see the extent of the damage and either a microfracture or graft to patch it and cover up the raw bone end, depending on how bad the damage is. Be prepared to be told 2-3months on crutches if they have to do that, plus rehab.
Title: Re: help with results of my MRi
Post by: brianwith2ndknee on October 08, 2011, 04:11:30 PM
Hello , I am a 35 yr old male that had similar problems . My first operation was a scope with microfracture . They did not see much on the MRI , but once inside they did notice more issues with my deterioration of my cartlidge . They proceeded with the microfracture and that recoup was about 3 weeks . It lasted about 15 mnths and I am 1 week out of surgery with an OATs procedure , reconstruction , and femoral nerve block  . The OATs is a transfer of cartlidge to the effected areas of the knee . They actually say I needed a full knee , but do to my age we did the OATs . Some of the procedures are done with donor / cadaver parts , but they recommend having your own transplanted so the chances of rejection are very slim . I hope all works out for the best for you , as for me I am still 6 more weeks min. of non-load bearing and a long road to full recovery..
Title: Re: help with results of my MRi
Post by: snett on October 14, 2011, 07:29:49 PM
saw the doc and i have dimples in the load bearing medial femoral
condyle cartilage and they are going to try microfracture first and see how that works, but could depending on how bad it is when they get inside they might also have to try to graft some from other parts of knee.  They are saying 1 week no activity and then 4-6 weeks on crutches and a 4-6 month full recovery time, does this seem right for a micro fracture surgery? seemed like a long time for me   :(

Title: Re: help with results of my MRi
Post by: Lottiefox on October 14, 2011, 07:37:54 PM
Microfracture on a load bearing area does bring a lengthy period of rehab...I was told 6 weeks on crutches and NWB, then 6 weeks to wean off them, then no impact activity for at least 6 months depending on recovery. I opted not to have anything done.

How long have you had the sharp pain? I have degenerating patellas but my load bearing condyle injury happened during a series of sprints in a park on bumpy ground. I knew something had happened. I had very sharp pain to start with. Take your breath away pain. Then it became a dull ache. Now, 2 years on and with a course of NSAIDs and two Euflexxa injections I don't get the sharp pain. I think I may have created some form of natural scar cartilage (like Vickster) that cushions the defect a little. Probably not as good as MFX but hey. I avoided surgery.

I guess I am saying that sometimes these things improve with time. Sometimes they don't and they need surgery. At 39 you are at the upper end of MFX preferred age ranges although most OSs will do them up to 45 or so. Be prepared that if they find more damage and you end up with an OATs procedure your recovery may be longer but in theory the "plug" might be more robust. Check out Craig's post OATS diary - search for Dad3 (I think) and you should find it.

Good luck,

Lottie :-)
Title: Re: help with results of my MRi
Post by: elliottl73 on October 15, 2011, 01:50:48 PM
I am 38 and had MFX in January it has since failed and have had another scope to biopsy carlige to reimplant.  I am now waiting for my third surgery this year to complete ACI.  If you are still deciding what to do be aware it doesn't always work and you may want to ask about other options.

Good Luck,
Laurie :)
Title: Re: help with results of my MRi
Post by: brianwith2ndknee on October 15, 2011, 04:38:43 PM
As lottiefox had said be prepared for the oats if things are worse . I mad it 1 1/2 years after the microfracture and it was not to bad of a recovery . I will say you need to fthe rehab to a tee in order to avoid the muscle loss . I am now recovering from an OAT's procedure and re-construction due to another injury . This recovery is nothing like the micro fracture . Two weeks into rehab and I am still having issues control the leg response even though I am doing 3 hours of PT 3 days a week along with at home . If you have any questions please feel free to ask . Hope every thing goes well for you .