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Author Topic: Advice sought as to dealing with degenerative thinning of cartilage.  (Read 1842 times)

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Offline DaveS

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Hi,

!3 years ago I had about 3cms of medial meniscus removed from my knee as a result of a tear and recovered fully so as to lead an active life including playing most sports (badly) on a regular basis. About a year ago my knee started to get sore again so reluctantly I have had to hang up my trainers.

What is my interpretation of a recent MRI scan has shown that the remaining cartilage around the damage site has sought of eroded away narrowing the gap between the bones to about zero. The Radiologist puts this as 'degenerative thinning of the hyaline cartilage in the tibiofemeral and patellofemoral joint compartments' but I am not really too familiar with this sort of terminology so can only describe what I see on the scan.

Current symptons are soreness/pain plus reduced mobility. I am 57 but being optimistic hope to get active again. I did see a consultant after the scan but the time didn't seem to lend itself to me finding out all of my options. Another arthroscopy was recommended in the first instance, something I am a little loathe to undergo before I know what else could be done.

What I would like help with is to learn what options are available to me so as to try to overcome this problem if I can, and to hear from anyone who has successfully done so. I would also like any advice on dealing with cartilage thinning or to hear from you if you have the same condition.

Hopefully hear from some fellow Kneegeeks.

Thanks,

Dave S.

Offline Chris Cross

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Have you seen a physio? It may help to bulk up on the quads/hams.

Offline blackbeltgirl

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hyaline cartilage is articular cartilage.  Most everyone sees some thinning over the years, and at 57 it's almost expected.  The thinning of the cartilage is graded in 4 stages, grade 4 being totally down to bone. Basically, it's osteoarthritis.  You can't "heal it", but you can do more research.

You should have standing x-rays, to see how much joint space narrowing you have when weight-bearing.  X-rays will also show any bone-spurs - your body's attempt to heal itself.  Physical therapy can strengthen the muscles and reduce some of the pain symptoms, and potentially slow down degeneration.  There are surgical options to "clean up" the joint - basically cut away any loose "threads" to reduce pain from things catching in the joint, and hopefully slow down the degeneration.  YOu can try taking suplements like glucosamine chondroiting.  But at 57, if you have some minor arthritis there's not that much they can do to make it better.  Non-impact sports will help you stay fit and healthy - try biking, or the elliptical trainer, or swimming...

If you want to really push yourself, look for a sports medicine OS who specializes in knees.  That's your best bet to get back to your sports.  But again, there's only so much they can do.

Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline DaveS

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Chris & Jess,

Thanks for your prompt replies to my post.

I have already followed some of your advice & today visited a friend who is an orteopath, she has set me up with a few excercises so as to strengthen my leg & thus hopefully support the knee more. She also explained the MRI report more which boosted my confidence especially given that I was left with concerns after the consultant had touched on the various knee replacement techniques currently available.

According to the scan the thinning is mostly grade 2 so from what you have said this equates to about half way up the scale (half worn?). Recent standing x-rays suggest the bones are nearly touching on the inside at the back of the knee which was the area previously damaged.

I have been using my bicycle but tend to favour the good leg somehow as it doesn't take much to make the injured one sore/ache. Will try swimming more as suggested. I am also taking the supplements mentioned. I do hope to be able to get back to the sports stuff sooner or later.

As an aside, what is a sports medicine OS?

Thanks again, I hope you are making progress with your own knee problems.

Dave S.



Offline blackbeltgirl

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A Sports medicine OS is just one who specializes in caring for athletes - professional and weekend.  They tend to be up on the latest techniques, and more aggressive at helping you return to your chosen activities.  Especially at your age, you're likely to get a lot of drs who tell you to live with it as long as you can, and come back when you're ready for a TKR.

Another question to ask is which compartment is affected - lateral, medial, or patellofemoral.  If the damage is in the medial compartment there is a brace called an unloader that redistributes your weight through the joint, and may get you back to more activities.  Also, if it the damage is isolated to one compartment you may have the option of a unicompartmental joint replacement - less invasive than a TKR, and it leaves you the option for a TKR as needed later in life.

Good luck-
Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)















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