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Author Topic: Chondral fracture????  (Read 4398 times)

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Offline texredbird

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Chondral fracture????
« on: December 27, 2006, 06:25:46 AM »
Hi folks, new to the board, but not knee problems.  I just had the second arthroscopy to repair a torn meniscus.  This time however, the doc said the I had a "very serious" injury.  He said it is a chondral fracture and the only way to fix it is through an open knee surgery and that the rehab would be very long.  He confused me then by saying that he wanted to start intensive physio therapy and medication.  Neither of which did he start. I go back to have the stitches removed on friday.  I suppose he will start it then.  He showed me a pic of the fracture....looks like a long crack in white material. He said that the instrument that was stuck inside of it on the pic is 7mm long and it was completely buried in the crack.  I am having trouble finding info on this type injury...it doesnt' look like the pics I've seen online...it is literally a crack.  He said tht they would have to take cartilige from another part of my body and put it into the crack. I don't understand how PT would help it...or is the PT for the surgery I just had?  Also this is a worker's comp deal and they are denying responsibilily stating that it is degenerative in nature....I can't find any info that states this type of injury could be cause from degeneration....chondromalacia...yes, but a chondral fracture?  Sorry for ramblin....just really confused.  Thanks, Robin (texredbird)

Offline hntndaylight

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Re: Chondral fracture????
« Reply #1 on: December 27, 2006, 06:37:53 AM »
My post op report showed chondromalacia, where I had hunks of cartiledge knocked off and scratched in the accident, all the way to bone. He reported polishing them to bleeding bone and thats it, no other cuts on my body. With all the other junk going on plus this they want me on intensive rehab, in terms of duration, but its only strenght and control for 30 days (starting 2 weeks post op), followed by passive range of motion using gravity for 90 days. Then if the Xrays and MRI are ok we start more active PT, for 14-18 months. Not sure if this is remotely what they are talking about on yours or not.

David
40 years old
R. k. ruptured PCL, MCL, tibial plateau fracture, and  double  meniscus tears in farm accident, Oct 15, 06.

Reattached/repaired scope and open knee surgery Oct 27, 06.

R.K 'clean up'  meniscus, plica, scar tissue, arthritis with scope Dec 28, 2007

Absent ACL found Dec 28, 2007

Offline shade

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Re: Chondral fracture????
« Reply #2 on: December 27, 2006, 10:52:52 AM »
Robin,

Hi there....

Sorry about your injury, it's interesting that WC mentioned it being degenerative - everything I've read states this type of injury is caused by trauma to the knee.  Think the treatment you mentioned would be like an OATs procedure.  I've had an OBI TruFit BGS plug inplanted behind my patella for a similar condition.  The OBI is basically a synthetic OATs procedure.  My injury went into the subchondral bone (subchondral fracture).  I've had a very good result to date with my injury and my leg is back to being strong again.  They also did a TTT at the same time to unload my patella and relieve any stress to the damaged area.

Here are some articles..... 

Chondral Fracture
An articular cartilage (chondral) fracture occurs when there is trauma to the joint surface without breaking the underlying bone. This most often occurs when the bones are forced to slide across one another with marked force. This can occur, for example, where the tibia and femur meet, and may be caused by a twisting force, as happens when the Anterior Cruciate Ligament tears.  A chondral fracture may also occur where the kneecap and the femur meet, and may be caused by a subluxation or dislocation. 

http://www.ajronline.org/cgi/content/full/174/4/1099

Here's a site that explains the OBI procedure  http://www.obi.com/products_TruFit.htm

Good luck and let us know how everything goes.  ~shade
« Last Edit: December 27, 2006, 10:56:59 AM by shade »
July '05 (RK) - LR/debridement
Mar '06 (RK) - Open LR + Allograft w/OBI TruFit Plug + Fulkerson TTT
 Feb '07 (LK) - LR + Fulkerson TTT

Offline texredbird

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Re: Chondral fracture????
« Reply #3 on: December 27, 2006, 10:55:24 PM »
Thanks for the replies...  I will see the Ortho on friday.  I have lots of questions for him.  I didn't know what to ask him before because I was shocked at what he told me....I thought he was able to repair the meniscus and that was all that was wrong. I suppose I will wait until I hear more from WC to decide if I need to seek out a lawyer.  I really don't want to lose my job and I am afraid this just might do it.  But I do know that the case worker I have is a real jerk.  My doc says he hates to even talk to him.  I can't find any confirmation that this type of injury could be anything BUT from an accident. I had the same knee injured twice at work.Thanks for the info on the injury and the OATS...that does sound like what he was talking about.  Thanks again....Robin (Texredbird)

Offline Garnet

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Re: Chondral fracture????
« Reply #4 on: January 10, 2007, 02:32:58 AM »
Sorry to hear you have to follow up with more surgery, but the sooner you do it the better.

 I had the same problem but didnt realise it and kept working in agony, not realising I was destroying my patella. February last year I had a lateral release and chondroplasty, my OS said the back of my patella was a mess and didnt expect it to that degree and hoped that would solve the problem but couldnt guarantee it. I went into denial and didnt go back until I could hardly walk. After a bone scan he quickly had me back in surgery to thin the patella and bring it away from grinding on my other parts of my knee,(unloading the patella from compacting on other surfaces of my knee)  what he didnt expect is that I had worn all cartilage away and had ground a hole straight throught the patella.  He had to thin my patella , screw it back together and plug the back of it with false membrane called periosteal. 

So dont hesitate in getting yourself into surgery.  I  ended up with patello femoral arthritis caused by mechanical use of the knee not the biological arthritis.  My OS has now said it is degenerative and will worsen and there is no going back for me now. I eventually will have a TKR but we are putting that off.

Take care and keep us posted
Wyn

Lt TKR July 07
Lt thinning of patella,osteotomy, periosteal graft,
hole in patella,loss of cartilage Oct 06
Lt lateral patella release/chondroplasty Feb 06
Rt shoulder acromioplasty
Back injury,disc bulges,one degenerated
Hip bursitis
Cortisone lt knee,lt hip,rt sacrolliac joint,2 rt shoulder