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Author Topic: Anyone have Chondral Defect in Trochelear Groove, Help???  (Read 35761 times)

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Offline Shine

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Re: Anyone have Chondral Defect in Trochelear Groove, Help???
« Reply #30 on: October 24, 2008, 04:51:27 AM »
Hi Heather,
I was thinking of you and was going to email u to see what happened but you beat me to the chase. I'm sorry that you can't return to your old job. That must be really hard to take. So what the OS plan after you get your quads back. Does he think that will be enough for you not to be in pain or does he think that he will do another surgery on you? It will be interesting to see what his pt does differently. I guess from personal experience I can tell u that I have worked with a couple of pts and a good pt actually helped me get my muscle bad. I think if I would have stuck with the regular pt I would not have gotten as far as I have gotten. Yeah, I bet your pt is frustrated. That sucks if he has worked really hard and you have progressed. Just give the new pt a shot though. You never know he might have some new tricks up his sleeve. I have the same thing on the PF compartment is not good. Don't worry you will find a solution that works for you. You are too young to live with pain. Thats what I keep telling myself to. Take Care and talk to you soon! Summer

Offline heather rae

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Re: Anyone have Chondral Defect in Trochelear Groove, Help???
« Reply #31 on: October 24, 2008, 01:15:55 PM »
Hi Summer:

Ya know what's perplexing? The new doc didn't even bother to ask what I've been doing for the past 15 months of PT. I have had about a million exercises and have done both aquatics and land-based.  Until recently going back to the water class, it's been ALL work hardening stuff. For example, the quad slide board, stair master, treadmill (all directions), abductor machine, ball squeezes, board push, theraband exercise including squats, short arc quads, leg-press and curl machines, just to name a few. I also walk all the time, too.

My PT thinks pain will continue to hinder my quads, I tend to agree. Maybe the new one will figure that one out relatively soon, if he's that good. Mine has had me to keep the weights to my comfort level. Anything that causes pain over a 5 on the scale is avoided. The only thing I can figure is that I'll just have to push through ALOT of mind-blowing pain to work the heck out of it and see what happens. Did you? I'm also convinced that other muscle groups are compensating when I'm exercising.

I'm not sure what the new doc plans to do. He didn't even schedule me to return. He just said to make an appt if I needed to. My long term options on this if pain continues if/when the quads get better, would be to remove the kneecap or a joint replacement of some sort. UGH!! No way!  :-\

You're right about us being to young to have to live with pain everyday!!! Really, anybody is. It's unethical to be told that you HAVE to. I plan to go to pain managment if push comes to shove. Have you been to one? What exercise were you doing to get your quads back? Whatever is was, I think I need to be doing them, too!! Well, here's my theory... you work the quads like dogs  :P and push it as hard as you can. In the mean time, the cartilage (if there's any left by then) just wears out more and more. And then.... it's anybody's guess as to how we'll manage to get around.

So, here's my plan... I'll do what the doc says and then some. If the new PT along with my aquatic stuff and home regimen still doesn't help, there's a PF specialist 2.5 hours from here and I'll be at his door with bells on.  ;D He's on patella MD if you want to check it out. Lots of info!!! WOW! You're welcome to join me if you'd like!! Take care and hope that calf is having an ok day... hope to chat with ya soon!!

Heather 8)
5/10/07- Comminuted-20 frag., displaced L patella Fx
5/15/07- ORIF L patella, Bledsoe brace, crutches
7/07- PT 3X/week
8/07- Brace off, ambulate without crutches
9/27/07- Hardware removal, MUA, crutches x 8 wks 
6/08- J-brace for lateral maltracking, Cont. PT
8/08- Referred to soft tissue OS

Offline Shine

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Re: Anyone have Chondral Defect in Trochelear Groove, Help???
« Reply #32 on: October 24, 2008, 09:09:14 PM »
Hi Heather,
I pushed through alot of pain last year before Dr. Steadmans surgery. And no matter what I did the quads did NOT come back. So when I went to see Dr. Steadman I asked him if I did more pt if it would help. His answer was, you have been trying for a year and it hasn't worked so its not going to work. I think you should go get another opinion. Make an appt. with the guy 2.5hrs away. Because if you have been trying for 15 months and its not coming back then is it really going too? In the meantime, just see the new pt to see if they can help. After Dr. Steadman's surgery I have not been allowed to do exercises that cause pain. A little twinge now and then of level 1-2 pain is okay but anything past that is not okay. He and the vail pts do not believe in the theory no pain no gain. I think they think if I am getting pain I am probably doing more damage to the cartiledge. So for now, all I am doing is riding the bike with resistence, squats not too low on bosu, single leg squats not to low, wall sits not to low. Dr. told me last time it would be good for me to walk on the treadmill backwards too. The rest of the stuff I do is  all glute, hamsting and core. I do not have pain with these exercises and if I do they get modified or taken out. They told me to really listen to my body and not do things that cause pain. Its a different way of doing pt, cause I think pts down home just say work through the pain. But I think the Vail method works much better! Can you swim without pain? That might be an option too, or aqua jog. For me, swimming hurts so I don't do it. I also think its wierd that the new Dr. didn't say come back in a month so that he can follow up on your progress. I don't know, I feel like he might not know whats wrong. Remember I went to 4 local dr.'s and they didn't know whats wrong. I know it may seem crazy to fly out to see a Dr. But maybe you can make an appt. to see Dr. Steadman? I really think that my knee is much better only because he did my surgery and because I got good pt in Vail. I say don't wait too much longer to get other opinions too, cause you don't want to damage your knee anymore than it is. Sorry, if this may sound negative I just don't want to see anyone given the wrong advice by there OS and then suffer more damage. Take Care, Summer

Offline heather rae

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Re: Anyone have Chondral Defect in Trochelear Groove, Help???
« Reply #33 on: October 25, 2008, 12:50:14 PM »
Hi Summer:

YES! I am exicted about something now. My PT has absolutely been correct in his way of rehabbing me. Anything that causes pain like that has been cut or modified for me, too. He did say that what you have after a year pain/strength wise is just about it, too. Are some docs just more trusting of their own PT's or something? The only way I can see getting these stubborn quads back is to try the old theory of pain and gain because we've proven this way isn't working for me. I don't want to do it, though. Yes, the cartilage damage will get worse, and then what?

I can swim with a floatation device but, MAN does it hurt!! I stay away from it, too. I really like the water PT class so, I do plan to stick with it along with 1x/week with the new guy. There's a couple of things they do that I can't, like the jumping exercise, but that's ok, I just skip it. Water is just better all around!  ;D

Well, I can't say that this doc doesn't see what's wrong. He agreed with my doc about patellofemoral arthritis. I even showed my PT my x-ray yesterday and he said that PF compartment looks bad as does the rest of the kneecap. There's also a PT assistant who works there and has currently been studying radiology. He checked it out and he said hmmm, looks like you don't have much cartilage left there. There's also a chipped out area on the top of the patella that's now rectangular shaped and it's mostly dark and shadowy looking, too.  ???

I am sincerely hoping this doc's PT is as good as mine. If so, he'll soon realize what my PT is saying about the pain and quad shutdown and relay the message to the doc. I will make another appt to see the doc if he advises me to. Then, if he says live with the pain or the patellectomy, I will go to Lansing to see Dr. Schneider. He only deals with patellofemoral problems only. No referral needed!!  ;D I shot him an e-mail explaining my situation and then mentioned the quad dilemma. I asked if he had any success with similar patients. If he mails back and says yes, I'm soooo there!! How far was your flight to Steadman?

Take care and hope you're having a good day. Tonight is my kid's 13th B-day bash... YIKES. It'll be kiddy city here and I'll be up in the barn rafters with a glass of wine... HELP!!  :o I have asked 10 other adults for help so, I DO hope they all keep their promises. That's ok, I'm sure they'll be asking me for help at some point, too!! Hope to talk with you soon  ;D

Heather
5/10/07- Comminuted-20 frag., displaced L patella Fx
5/15/07- ORIF L patella, Bledsoe brace, crutches
7/07- PT 3X/week
8/07- Brace off, ambulate without crutches
9/27/07- Hardware removal, MUA, crutches x 8 wks 
6/08- J-brace for lateral maltracking, Cont. PT
8/08- Referred to soft tissue OS

Offline Shine

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Re: Anyone have Chondral Defect in Trochelear Groove, Help???
« Reply #34 on: October 25, 2008, 09:40:06 PM »
Hi Heather,
Ahh 13th birthday! How fun! Have a good time today. Yeah I hope this new pt is good and will realize and just tell the new Dr. What is a  patellectomy? My flight to Dr. Steadmans was about 2 1/2 hrs. Not too far. Yeah I think some Dr.'s do trust there own pts. I know in Vail the pts work really closely with the Dr.'s there. Hope you get some answers soon. Also, it would be nice if the new pt can help u get more quad back too. Try to really concentrate and tell yourself to make your quad work in your head. That has worked for me. Although it took me 6 wks of doing this for the quads to work all the time and my hamstrings to compensate less! Have a great weekend! -Summer

Offline heather rae

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Re: Anyone have Chondral Defect in Trochelear Groove, Help???
« Reply #35 on: October 26, 2008, 05:41:35 PM »
Hi Summer:  ;D

I survived the party... lots of kids and parents here last night. My house is still full of girls who stayed over. They're driving my son crazy but, they're helping my hubby to clean up the barn now. Thank goodness, my knee hurts, ouch!! I must've worked the hamstrings in doing all this work, they're pretty sore, too. Nothing whatsoever in the quads though. I do try to focus really hard on the exercises but, more in doing them correctly. Make sense? I'll try the mind over matter technique on the quads next time at PT. Thanks for the tip... hope it helps me, too.

I'm glad your flight to Dr. Steadman wasn't too long. I've flown since I've been injured and the cabin pressure really bothered my knee. I'm not sure if that will get better or worse over time. Did that happen to you, too?

Well, a patellectomy is complete removal of the kneecap. That is an old procedure that's supposedly been replaced by the PFJR. Given the removal of the patella as the doc's solution to removing the pain, I'm not sure why he still uses an older technique. That's what he would do if I can't get better. I'm not very keen on that idea as he did say I may need a joint replacement down the road. Think I'm up a creek without a paddle? Does your x-rays look the way I've described mine? The machine used wasn't standard x-rays, it was pretty detailed almost like a sketch. Lots of black areas around the PF joint and white areas of cartilage on the medial/lateral sides.

Hope you're having a good day... I'm resting for a long while here. I've skipped my a.m. exercises and hope it is better by later on to do the p.m. stuff. Take care and I'll chat with you soon!  ;D

Heather

5/10/07- Comminuted-20 frag., displaced L patella Fx
5/15/07- ORIF L patella, Bledsoe brace, crutches
7/07- PT 3X/week
8/07- Brace off, ambulate without crutches
9/27/07- Hardware removal, MUA, crutches x 8 wks 
6/08- J-brace for lateral maltracking, Cont. PT
8/08- Referred to soft tissue OS

Offline Shine

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Re: Anyone have Chondral Defect in Trochelear Groove, Help???
« Reply #36 on: October 26, 2008, 10:27:20 PM »
Hi Heather,
Yes the cabin pressure bothers me. I always put ice in a ziplock bag and ice. It does get better. The last time I flew about 6 wks ago. I didn't need ice:) Yeah I can imagine with all the kids. I don't remember the x-rays. I had MRIs which I can't tell what is what on!:) Have a great day! Summer

Offline heather rae

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Re: Anyone have Chondral Defect in Trochelear Groove, Help???
« Reply #37 on: October 27, 2008, 05:31:07 PM »
Hey Summer:

Hope you're having a good day, how's the calf holding up? My hamstrings are better today. Rest and a hot bath did the trick. YAY! The stupid knee still sucks, though.

I'm glad to hear the cabin pressure with flying gets better, too. That was nasty, I remember. It just added pressure to the painful pressure already in there. I did have an extra seat next to me to prop the leg on. Betcha icing would've helped, too. Smart move on that one!  ;D

Have you ever heard of Protronix (I think) PF bracing? My PT said that's the only thing we haven't tried. I'm going to shoot it past the new PT on Thurs. and see what he thinks. Gonna give it one last ditched effort to get my quads back and it may help. Guess it's big and rather bulky, though. Been wearing the lateral J since May and no results. I would surely think that this PT will tell me when he thinks he's gone far enough with this dilemma, too. Atleast he has easy access to talk with the doc all the time, they're in the same office.

Oh, BTW: If you're interested, as I was looking for this brace online, I happened across some really good advice on eorthopod.com. about patellar arthritis. Interesting stuff if you'd like to check it out, WOW! Hope to hear from you soon, I'd love to hear your opinion about the options on the website... it's pretty scary. TTYL...

Heather  ;D
5/10/07- Comminuted-20 frag., displaced L patella Fx
5/15/07- ORIF L patella, Bledsoe brace, crutches
7/07- PT 3X/week
8/07- Brace off, ambulate without crutches
9/27/07- Hardware removal, MUA, crutches x 8 wks 
6/08- J-brace for lateral maltracking, Cont. PT
8/08- Referred to soft tissue OS

Offline Shine

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Re: Anyone have Chondral Defect in Trochelear Groove, Help???
« Reply #38 on: November 06, 2008, 05:52:32 AM »
Hi Heather,
How's the rehab going w the new pt? I hope it going better and your quads r working:) I have never heard of that bracing. I've never tried bracing so don't know much about it. Sorry it has taken me so long to get back to you. Things have been very crazy in my world.  I couldn't get into the site. FYI, i just got another round of PRP injections. I talked to someone that works in the office and they said that some people are doing studies on it for growing cartiledge back. Hopefully, the results will be good. Another option for us, maybe. Let me know how things are going with you. Summer

Offline Heathers new knee

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Re: Anyone have Chondral Defect in Trochelear Groove, Help???
« Reply #39 on: November 06, 2008, 11:20:39 PM »
Hi Summer:  ;D

Hope all is well with you and the PRP injections... fingers crossed. My quad tendon has been fussy again..sore, tender. The new PT doesn't want to do anymore modalities on it because ionto. has been used 3 times. I've just ben hitting the ice on it.

So, I've had 2 PT sessions with him, the first one nearly killed me, LOL! Seriously, the muscle strain was quite bad for 3 days from the hip to the knee. Everytime I tried to stand in it, it wobbled like it was gonna collapse and MAN! Did it ever hurt! It even hurt to sit on my hammys. So, today, he backed off and it's the usual cranky knee thing after PT. Still hitting the ice every couple of hours. I do have something new now.... gosh I'm excited. Is that bad? It's called the shuttle aka rocket science in my book, lol, kinda like leg-press without weights and it's unloaded as you are completely lying on your back. The objective is to do as many single leg push-ups as you can in 5 min. My leg ran out of gas at about 2.5 min but, I made it Yay!!  ;D

So, I've had an interesting offer by the doc on Patella MD. He's the closest PF guru to me. I e-mailed him to ask about quad strengthening as I've been stuggling with it for years now, lol and if he knew of better bracing option. I also mentioned the patellectomy as a last ditched effort to get rid of the pain. He told me to send all of my x-rays to him. He looked at them and his nurse called me back today. She said he can help me and thinks resurfacing would be a good option.  ??? I have an ASAP appt. next Tuesday. He doesn't mess around.  ;) ok, guess I'll go, would you?

I am very excited about technology for cartilage regrowth, aren't you? Are the studies being done in your doc's office, too? The PT assist. where I've been going has told me her bro-in-law lives in Florida and had it done there on both knees.... quite successful, too!! Take care and hope you're feeling back up to speed very soon. Keep me posted ok? TTYL...

Heather
5/07 Sev. comminuted,displaced L patella fx,ORIF,brace,crutches
7/07 PT
9/07 Hardware removal,MUA,crutches,PT
5/08 J brace,patellofemoral arthritis,PT
12/08 Appt w/ patella specialist: L-TTT,LR PFJR,scope,scar tissue debridement-1/26/09
8/09-RSD,PT
2/10-TTT screws removed,scar tissue debridement















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