Advertisement - Hide this advert





Author Topic: new to board - have severe cartilage damage  (Read 3921 times)

0 Members and 1 Guest are viewing this topic.

Offline swayball

  • Regular Poster
  • ***
  • Posts: 71
  • Liked: 0
new to board - have severe cartilage damage
« on: February 27, 2008, 12:51:36 AM »
hey all, just signed up though I have read some posts here in the past. I'm particularly frustrated this week with my knee since doc said yesterday there wasn't much he could do and I'd spend my life avoiding a knee replacement. I am 37 and injured my knee in a rear end collision almost 3 yrs ago.

In the past he and different PT's had made mention of various surgeries (OATS, readjustment, more arthroscopy, and microfracture) - I'm kicking myself that I didn't inquire more yesterday about the possibility of other procedures. I would like to think something can be done other than to just live with it as is

Offline dm

  • SuperKNEEgeek
  • *****
  • Posts: 1304
  • Liked: 19
  • I hate my knee!! :(
Re: new to board - have severe cartilage damage
« Reply #1 on: February 27, 2008, 02:41:04 AM »
Are you referring to articular cartilage damage? some people mistakenly call the meniscus cartilage, and it isn't the same thing as articular cartilage at all.

First, find out exactly what they say is wrong, and how severe they rate the damage. Has your knee been scoped, meaning have they gone in there and looked around, or are they just going by an MRI? An mri is not perfect, sometimes things don't show and are found when they scope the knee.

Second, do your research and find out exactly which of the options they mention are most likely to improve your functionality to what you want. Get real, and look at the possibility of failure with options such as OATS, and that microfracture may or may not do any good, depending on a lot of factors, etc, etc. If you don't do the research, you can't make an informed choice about the procedures and how they will affect your activities etc.

Third, If you haven't done so, take your most recent MRI, xrays etc and get a second opinion from someone who specializes in knees. It can't hurt to have the dr's opinion validated, or disagreed with. Sounds like you've been with your doc some time, but sometimes a fresh eyeball on the problem brings new options.
multiple arthroscopies 2/00,3/01,6/01,1/03, 12/07,10/10. chondromalacia, severe medial joint space narrowing following 3 partial menisectomies, chronic pain problems, kneecap problems, OCD lesion, failed mfx.

Offline swayball

  • Regular Poster
  • ***
  • Posts: 71
  • Liked: 0
Re: new to board - have severe cartilage damage
« Reply #2 on: February 27, 2008, 06:58:54 AM »
thanks for the response - yes i had arthroscopic surgery in jan 07 which is when he discovered how bad the damage was. it is articular cartilage on the patella and another place maybe tibia? I think it is grade 3

sounds like its time for a second opinion? I'm realizing if someone suggests surgery it is ultimately up to me to do tons of research and make the decision. I have heard good and bead results and know things could actually get worse

tough decision - i notice many people on here have had lots of surgeries!

Offline eaglemom

  • SuperKNEEgeek
  • *****
  • Posts: 741
  • Liked: 1
Re: new to board - have severe cartilage damage
« Reply #3 on: February 28, 2008, 12:57:39 AM »
Its hard to think of getting a second opinion if your not unhappy with your os.  However, you really should do it.  I know in my case personally I soon realized the os that I was using was very conservative and close minded.  When I met the os I'm now using we just "clicked" and it wasn't hard to call the first os and have them send the records over!  Sometimes other's see the picture a little differently and can give you a clear idea of what is going on.  Eagle

Offline kathat

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1520
  • Liked: 1
  • Aussie, Aussie, Aussie
Re: new to board - have severe cartilage damage
« Reply #4 on: February 28, 2008, 12:48:54 PM »
I agree that a second opinion is warranted, especially considering your doctor has said there is nothing more to be done. Are you seeing an orthopaedic surgeon who specialises in knees? There are ones who specialise in cartilage restoration procedures, ones who specialise in treating patellofemoral issues, ones who specialise in knee replacement, and so on and so on. So there are many places to get a second opinion from. I'd ask around and try to find one that has been recommended many times (there are many suggestions around the board - you'll find the same names crop up over and over) and if you pick one near you that has treated problem similar to yours then you have a good starting point. Good luck.

Kathy

Offline Beda

  • SuperKNEEgeek
  • *****
  • Posts: 824
  • Liked: 1
    • Bedas Atelier
Re: new to board - have severe cartilage damage
« Reply #5 on: February 29, 2008, 11:33:29 AM »
Hey there. I just read your first post, that your 37 and the doc says youll spend the rest of your life dodging a knee replacement. Excuse me, but this is BULLSHIT! You have a long way to go beofre you consider anything that even looks like a knee replacement, and at the age of 37, an OS hasnt any business putting the idea through your pretty head! (see In'spirtual guidence etc.. new OS at end of the road. Too many TKR's BEWARE') Sorry, but being put pretty close to an amputation because of having too many knee replacements at an early age, I feel bound to warn you!
Hope everything goes well for you
Beda
'79 trauma v.knee
'81surgery patella lux.
'84 osteochondritis dissecans
'86 osteotomy
until now 16 knee surgerys ink. 6 failed tkr. pretty much exhausted all areas and types of surgical proceedures for knees
all TKR's loosened & failed
2008 wait for Final arthrodesis
constant pain

Offline swayball

  • Regular Poster
  • ***
  • Posts: 71
  • Liked: 0
Re: new to board - have severe cartilage damage
« Reply #6 on: March 06, 2008, 03:14:17 AM »
Thanks for all your responses!

Beda, he was telling me that to say how serious my injury is, not to suggest I have a tkr - In fact, he went on to explain that they can be unsuccessful, won't last forever, etc... In no way was he suggesting I have one now.

Kathat, I do have someone in mind to see who specializes in articular cartilage injuries - assuming I can get an appointment

Eaglemom, yes, I do like my current OS and appreciate that he is conservative. Actually, I hesitate getting a second just because I trust him so much - but just an opinion can't hurt

Offline Beda

  • SuperKNEEgeek
  • *****
  • Posts: 824
  • Liked: 1
    • Bedas Atelier
Re: new to board - have severe cartilage damage
« Reply #7 on: March 06, 2008, 07:28:36 AM »
sorry to hear your injuries are so severe. I really do hope the OS can help you one way or the other, and I'm sure he'll do his best to avoid TKR. It sounds like hes a reasonable OS.
Hope all goes well for you
beda
'79 trauma v.knee
'81surgery patella lux.
'84 osteochondritis dissecans
'86 osteotomy
until now 16 knee surgerys ink. 6 failed tkr. pretty much exhausted all areas and types of surgical proceedures for knees
all TKR's loosened & failed
2008 wait for Final arthrodesis
constant pain

Offline Janet

  • SuperKNEEgeek
  • *****
  • Posts: 3679
  • Liked: 2
Re: new to board - have severe cartilage damage
« Reply #8 on: March 07, 2008, 03:19:19 PM »
I also had damage to the articular cartilege behind the patella. It all started with a serious injury from slipping on a wet floor, of all things. After having three surgeries in three years, we tried many things over the next several years before I had a TKR at age 49. We tried extensive PT, cortisone, a brace, Synvisc, surgery to clean up the ragged ends (and maybe some other things, can't quite remember). I got opinions from three surgeons before agreeing to the TKR. You would do well to get another opinon and try absolutely everything besides a TKR until there are no options left and you can't live with your knee because of the pain. Good luck!

Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline swayball

  • Regular Poster
  • ***
  • Posts: 71
  • Liked: 0
Re: new to board - have severe cartilage damage
« Reply #9 on: March 08, 2008, 06:01:15 AM »
Thanks Beda and Janet, I'm wondering if something like cartilage transfer would work for me - my OS had mentioned it in the past - though I suppose any surgery can maybe do more damage. It's so hard to have to make such decisions.
I'm really not in a lot of pain since I just baby it and don't do much - but at 37, I'd like to be able to walk my dog or walk around the mall or something without too much pain. Maybe I'm asking too much and should be glad I can walk even the short distance I do? I don't want to risk making it worse.

Offline Beda

  • SuperKNEEgeek
  • *****
  • Posts: 824
  • Liked: 1
    • Bedas Atelier
Re: new to board - have severe cartilage damage
« Reply #10 on: March 08, 2008, 07:40:28 AM »
Hey There! I think what you say, that youre really not in a lot of pain, so then you shouldnt really have surgery. Wait for surgery until its the last way out, because youre quite right in thinking it might make something a lot worse, who knows what they'll find when they operate on you. Also in view of your young age. I am sure that you can get some NSAIDS to help the pain. The thing with cartilage grafts are, they are seldom sucesses, because cartilage has a very poor blood supply, and for tissue to bond, it requires a good blood supply. I once was a candidate for a cartilage transplant, and the OS opted for an osteotomy simply because of the poor results with grafting. So hang in there, just go for short walks, and dont over do it with strain on your knee, and take regualry a gentle pain medication just to tide you over, and you'll find that that probably is your best bet for now.
Hope everything goes well for you
Beda
'79 trauma v.knee
'81surgery patella lux.
'84 osteochondritis dissecans
'86 osteotomy
until now 16 knee surgerys ink. 6 failed tkr. pretty much exhausted all areas and types of surgical proceedures for knees
all TKR's loosened & failed
2008 wait for Final arthrodesis
constant pain

Offline Janet

  • SuperKNEEgeek
  • *****
  • Posts: 3679
  • Liked: 2
Re: new to board - have severe cartilage damage
« Reply #11 on: March 09, 2008, 09:03:02 PM »
If your damage is behind the patella, cartilage grafts don't work well. They are more successful in other parts of the knee, although even then there is no guarantee. You are right to baby your knee and avoid surgery as long as you can. I understand wanting to walk, but in the long run, if you can go about your "daily activities of living" without pain, that may be as good as you can expect right now...and be happy with that.

Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline swayball

  • Regular Poster
  • ***
  • Posts: 71
  • Liked: 0
Re: new to board - have severe cartilage damage
« Reply #12 on: March 10, 2008, 12:26:36 AM »
kind of bummer responses but I hear ya. Its not the pain as much as the limit of function. So at 37, I should just be glad I can do what I can? No more going for walks and food shopping is painful?
I will prob see someone anyway who specializes in this damage and see what he says but be prepared that he may say, like you that I should wait
Thanks!

Offline Shine

  • Forum Faithful
  • ****
  • Posts: 238
  • Liked: 0
Re: new to board - have severe cartilage damage
« Reply #13 on: March 10, 2008, 06:30:12 AM »
Hey There,
I am 31 and just saw Dr. Steadman. I don't know how my cartiledge damage compares to yours, but he did a chondroplasty. He said that should keep me out of pain when walking, but not sure about running/jumping. Though he thinks there could be a good chance that this will work but that too. If not, he said the only option would be a microfrature. My cartilage damage is behind the patella too. -Summer

Offline Shine

  • Forum Faithful
  • ****
  • Posts: 238
  • Liked: 0
Re: new to board - have severe cartilage damage
« Reply #14 on: March 10, 2008, 06:32:42 AM »
Oh Yeah, forgot to mention have you tried going to pt? Building up your quad and VMO muscles can help too from what I have heard.















support