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Author Topic: osteochondral defects  (Read 10970 times)

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Offline LouisaP

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osteochondral defects
« on: January 21, 2008, 11:16:43 AM »
Just had MRI results and news on both knees doesn't look good. Anyone else with this? Need advice on what gym work I need to be doing and anything else to avoid 'drilling' which was mentioned but not sure any further surgery is the best way forward.
hockey injury ACL repair - success
skiing injury - lateral maniscule tear repair
osteochondral lesions now


Offline Robin M.

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Re: osteochondral defects
« Reply #1 on: January 21, 2008, 04:37:34 PM »
Hi Louisa,

Welcome to the board!

I had osteochondral defects in both knees. In the left knee it was on the MFC. I initially had a scope and chondroplasty followed by PT, synvisc injections and finally a consult to an OS who specializes in cartilage defects. I had a mosaicplasty in Nov. 2005. Unfortunately in July I started to have problems again. I was diagnosed with donor site failure, though the mosaicplasty site is good,patellofem. and lateral compartments are now degenerating. In 2 wks. I have a consultation for a possible TKA. In the right knee initially I had a scope and chondroplasty which did not relieve the pain. I was not a candidate for a mosaicplasty due to the cartilage surrounding the defect(medial compartment) not being in good condition. I was diagnosed with medial compartment arthritis. In March2007 I had a HTO(high tibial osteotomy), my knee is doing very well at this point. The results will hopefully last 10-15 yrs. then I'll need a TKA.

In regards to a gym workout. You want to avoid anything that will stress the knee joint. You need to strengthen the muscles surrounding the knee and keep the quads strong. Riding the stationary bike as well as swimming are good to do. If I were you, I would talk to the OS or consult a PT on types of exercises to do that will not cause additional damage to your knee.

Good luck and take care!

Lt. knee- 6/04 scope and chondroplasty of MFC,11/04 Synvisc injections, 11/05 mosaicplasty, 3/06 scope,LOA and MUA, 1/08 degeneration entire knee, 5/12/08 TKA, 7/21/08 MUA
Rt.knee- 10/06 scope,,plica removal-OA, 3/07 HTO, 9/09 hardware removal  12/7/09 TKA 1/10,3/10 MUA, 11/10 LOA,partial revision

Offline plantgeek58

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Re: osteochondral defects
« Reply #2 on: January 21, 2008, 04:43:13 PM »
Hi Louisa,
I've had chondral defects in my right knee. The drilling you mention is probably microfracture, which is a common technique for dealing with them. Tiny holes are drilled into the subchondral bone to cause bleeding, which then produces a clot that stimulates the formation of fibrocartilage to fill in the defect. For some people it works well, and it can be done arthroscopically. Most OS like to try this before other more invasive techniques. The problem with it is that the cartilage that forms isn't as tough or smooth as the natural hyaline cartilage covering the bone, and it tends to break down again after a few years. I've had 2 microfractures, and haven't had good results with them.
There are other techniques you can look into that have better success rates, but they are generally more invasive, requiring open surgery, and the recovery periods are lengthy. They include OATS procedure, ACI and MACI. I've had one of my microfractures revised to an OATS graft with good results. ACI and MACI are relatively new, and not every insurance company is willing to cover the cost. You can find out more about all these techniques on the kneeguru's homepage. It would be a good idea to educate yourself about all of them, then go and talk with your OS about which might be right for you. I wouldn't recommend doing nothing about the lesions, because they have a tendency to get worse over time, causing more problems.
As for gym workouts, you can do anything that doesn't cause pain. It's always a good idea to build up as much strength as you can in your leg muscles, to support the knee joint. My therapists like to have me do the stationary bike, seated leg press, hip adductions/abductions, wall slides, mini squats and seated leg curls. They recommend staying away from the leg extension machine, as that puts too much pressure on the patellofemoral joint. You'll want to do some quad, calf and hamstring stretching also.
Hope this was somewhat helpful.
RK 7/04 part. m. menisc., plica resect., MF
    3/05 part. m. menisc., open OATS
    1/07 part l. menisc., MF, patellar chondroplasty
    9/08 MF
LK 11/04 & 8/06 part m. menisc.
     7/07 LR, patellar tendon debrid., part m. menisc.

Offline stgiles16

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Re: osteochondral defects
« Reply #3 on: January 23, 2008, 11:14:48 AM »
i have 2 defects in my left knee, both on the MFC. i have had 2 microfractures on one of the defects and the arthrosurface hemicap put into the second defect. dont know what is planned when the micro wears out.

pain during a workout is a sign that you should not be doing those activities. where are your defects located? that would help to decide what kind of exercises were good or not so good for you.
good luck
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
LOA & PKR 2/15/06
in pain mgmt
TKR JAN 2012

Offline celinenj03

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Re: osteochondral defects
« Reply #4 on: April 22, 2008, 01:31:05 PM »
I have a defect in my LFC. It's about the size of a quarter I believe. Grade 3. I had chondroplasty back in September. I don't have much pain in the area, but I feel like a speed bump there of something that the bone clicks over all the time. Is this normal?

Also, why do all of your MRI's clearly show your lesion and mine does not. My OS ordered an MRI for chondral lesion LFC but nothing came back. I know it's there, so how come it didn't show up. However the view you all got of the actual bottom of your bone, I don't have. Just side views. This is weird to me. I have no pictures showing the bottom of the bone so how do they know what is there.
Terrible Triad - 1/16/06 - Basketball
3/15/06 - Scope/Cleanout of to achieve full ROM
5/3/06 - Surgery-ACL Reconstruction-Allograft
9/12/07 - Large Loose body removed;Grade 4 Lesion on LFC
9/17/08-Microfracture, Lateral Release (all right knee)