Banner - Hide this banner





Author Topic: Knee Chondromalacia  (Read 4887 times)

0 Members and 1 Guest are viewing this topic.

Offline motopayton

  • MICROgeek (<20 posts)
  • *
  • Posts: 5
  • Liked: 0
Knee Chondromalacia
« on: March 23, 2010, 05:52:54 PM »
I was diagnosed with knee chondromalacia about a year ago when I was 17.

Currently if I were to stetch my quad by pulling my heel towards my but it would pop about 10 times and my pattella will slow up and skip about an 1/8 of an inch at least once.....

I am currently doing things to cure my knee for example, I wear high arch support insoles, walk very staight, stretch and recently have
been doing physical therapy exercises to strengthen my quadriceps for example
wall squats
leg squats
leg raises
bicycling
Icing after exercise...

Take NSAID's before physical exercise(such as motocross)

I have learned that physical exercise can only help prevent pain but can't ever cure it permanently???



What surgeries and cures are on the cutting edge of science that can help me get through my knee pain in the future???
Is cartilage replacement possible through stem cell? If it is how much does it cost? I want to get through the day without knee pain! What can I do??

Offline crankerchick

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1863
  • Liked: 26
  • How 'bout them Cowboys!
    • Derotation osteotomy & TTT Post-op diary
Re: Knee Chondromalacia
« Reply #1 on: March 23, 2010, 07:07:39 PM »
OoOh motocross. This is a topic I am getting so interested in as of late. Of course I'll likely never do it, I don't even know where I could in my area, nonetheless i'm so curious about it. Seems like it would be tons of fun.

Anyway, let's make a deal. You tell me about motocross, and I'll share what i know about knees.

I'll start:
First, sorry that you are having knee problems. It definitely sucks big time.

Second, chondromalcia. Well, it's just a term, used far too loosely, and also one that really just describes a symptom. It's not a diagnosis. The key to sorting out your knee problems is getting to the why. Chondromalcia is just one of the whats. It is the effect of something more happening in the knee--whatever is causing your patella to maltrack and cause wearing of the cartilage under the knee.

Have you had an x-ray of your leg? CT scan?

It's good that you are trying conservative methods now and working with a phisiotherapist and what not. But to answer your questions, is kind of hard, because you have to get to the why. Exercising will "cure" your problems if your problem is from a muscle imbalance or just general weakness of the quads. It won't cure your problem if you have an underlying structural problem, but it may make your symptoms manageable.

As for the future, in my opinion, instead of worrying about how to get back the cartilage that you might be losing, it is more beneficial to figure out why you are losing cartilage in the first place, ie why your patella is tracking off, and stop the loss of your own good cartilage that you were built with.

The keys to such in my opinion seems to be a knowledgeable patient combined with a good knee doctor with a special interest in the patello-femoral joint.
« Last Edit: March 23, 2010, 07:09:44 PM by crankerchick »
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline motopayton

  • MICROgeek (<20 posts)
  • *
  • Posts: 5
  • Liked: 0
Re: Knee Chondromalacia
« Reply #2 on: March 23, 2010, 07:47:27 PM »
Ya motocross is pretty much the most awesome thing in the world...If you wanted to start riding I could easily tell you the things you would need to start and where you could ride...
Just click this link and you can see all the places where people ride near you..
http://www.thumpertalk.com/forum/wheretoride.php

trail riding is where you would want to start... Trail riding is at your own pace fun riding through the woods and stuff wherever you want to go..

Im assuming your a girl so a good first time dirtbike would be... maybe a crf250x

It kind of depends on your height but this is an awesome bike

http://powersports.honda.com/2009/crf250x.aspx

heres a vid of someone ridin one
http://www.youtube.com/watch?v=d1e4UWngx7g


Riding motocross tracks is the main thing that aggravates my knee because of all the big jumps and constant stand up sit down squats you have to do...

I had a x-ray done about a year ago when my knee first started bothering me but the doctor only said it wasn't broken.. He didn't mention the apparant cause of pain or any mis-alignment. I'm not sure if they were even looking for anything that specific..

In the next month or two I am going to be really strict with my physical therapy routine and see If I can get any improvement...

If my knee continues to lose cartilage and get worse through riding and racing my dirtbike, where should I go to get my knee checked out?



Offline crankerchick

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1863
  • Liked: 26
  • How 'bout them Cowboys!
    • Derotation osteotomy & TTT Post-op diary
Re: Knee Chondromalacia
« Reply #3 on: March 23, 2010, 08:15:09 PM »
Thanks for the motocross tips and how to get started. I'm stilk recovering from the surgery in my sig, and still likely have a lot of work to do for strengthening and overall fitness before I coukd evn think about motocross, but that doesn't stop me now from living a bit vicariously on the internet, LOL.

Its funny that you posted a link to thumpertalk. I've been lurking there since september, reading he posts and like I said, living vicariously LOL.

Have you ever posted in the health and fitness forum there? It is moderated by a pretty good doc ;-) who would definitely offer some advise.

The key for you is twofold, educating yourself more on the subject and finding a good doc that will give you a full evaluation for all the different reasons you might have patella problems before recommending the right course of treatment.

Usually xray and ct scan if necessary are the best imaging tools for patella problems. MRI not so useful.

Where about are you located? As in state (you can pm me on TT if you prefer not to share on this thread)? I may be able to save tou the search hassle with a few doc recommendations.

But the key seems to be finding a doctor that will do lateral, ap, and sunrise ir merchant xrays. These would show things like patella alta or baja, malalighnment issues like knock knees a d bowed leg, and the tracking of your patella as your knee bends. A CT scan would provide information like if your bones might be twisted ir if your trochlear groove is shallow.

A common thing docs try to do is smooth the cartilage under the kneecap surgically, which can help with pain but doesn't address the root problems of why the cartilage is wearing in the first place. So the important thing is to try the conservative measures like therapy, bracing, and maybe even taping and hold out on any surgical procedures until you are thoroughly evaluate and are sure the surgical approach is getting at the root cause.

I'm on my mobile right now and have already typed enough, but I will check your links out when I'm at thedesktop pc. Let me k ow if you post over on TT in the healh and fitnesz section. I will come over and say hello.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline doublemom

  • SuperKNEEgeek
  • *****
  • Posts: 814
  • Liked: 1
    • Andi's Website
Re: Knee Chondromalacia
« Reply #4 on: March 23, 2010, 08:24:40 PM »
I have to say "ditto" to everything that Cranker has said (haven't I done that several times before, cranker? LOL!).  Chondromalacia just means wearing down of the cartilage, but it is not a diagnosis itself.  It's just a symptom of something else that is not lined up and working properly in your knee.  If it's muscle imbalance, PT and strengthening can do wonders to get the kneecap realigned so that the cartilage won't wear any more.  But, if it's something that is structurally wrong with the mechanics of your knee, PT can help but won't cure the problem.

You're young, and if you can get this figured out now you can save your own cartilage and not even have to think about any type of cartilage regeneration.  Then there's me... I've been dealing with knee problems since I was about 16, and never had a proper diagnosis for what was actually wrong until a couple of years ago when I was 40.  Now, I have at the least grade III chondromalacia (which isn't good) and will be having patella realignment surgery in two weeks.  If I had known when I was much younger, if I can seen doctors who were able to diagnose properly what was wrong and had it fixed then, I wouldn't be severely lacking in patella cartilage now.

Pay attention to what Cranker says, she is a wealth of knowledge and has gone through a lot to get where she is now recovering from her surgery :)

Andi
2000 R patella dislocation
2004 - Soccer injury - LK medial and lateral meniscectomies
2007 - Dx patellar tilt, lateral subluxation, grade III chondromalacia
5/13/08 - RK medial/lateral meniscectomies & patellar chondroplasty
4/6/2010 - RK TTT/LR scheduled

Offline motopayton

  • MICROgeek (<20 posts)
  • *
  • Posts: 5
  • Liked: 0
Re: Knee Chondromalacia
« Reply #5 on: March 23, 2010, 08:39:51 PM »
I just realized that I could probably get my insurance to cover asterisk knee braces

http://www.motosport.com/dirtbike/product/ASTERISK-CELL-KNEE-BRACES-PAIR/?catalogId=10

What do you think of these? It seems like it would help my patella track correctly and avoid weird angle bends.

Thanks for your help so far.. You should definitely buy a dirtbike sometime when your all healed up. I would rather not have a
knee then never ride a dirt-bike again.. that's how much fun it is.

Offline crankerchick

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1863
  • Liked: 26
  • How 'bout them Cowboys!
    • Derotation osteotomy & TTT Post-op diary
Re: Knee Chondromalacia
« Reply #6 on: March 24, 2010, 02:38:28 AM »
Your statement about rather not having a knee than give up motocross is exactly why i'm interested in it. I read the stories over on TT and can't believe some of the injuries and all the people want to know is when they can get back to riding despite pretty bad, sometimes life threatening, injuries. I figure anything with that kind of cult following must be really fun. But :sigh: my knees have been bad enough for long enough that I gave up sports and any thoughts of high impact activities years ago. I did get into mountain biking 2 years ago and was really enjoying doing that, but even that I rode quite tentatively and fearfully, which was hard for me because I'm someone who likes to push the envelope a bit. I'm the person that went down the side of a mountain on my backside because I didn't think I needed to slow down when a sign told me to...

It's not that I don't have the nerve to try motocross, more like I just know I'll be that person that hurts myself badly trying to do something I shouldn't have done (think going doing the mountain on my backside because I didn't slow down when instructed to..)! There are 3 guys at my work that have tried to get me and some friends out, maybe one day I will take them up. My doctor i think rides and he fixes a lot of people that ride, so that hasn't helped my curiosity, LOL.

Your link doesn't work for me, says item not found. I can't really comment on braces for riding since I don't ride and don't know much about it, but for that specific question, I really encourage you to post over in TT in the Health and Fitness section. The doctor that moderates that forum rides and fixes lots of MXers.

But I do know that a brace alone isn't fixing your problems, just helping to manage them.

I forgot to say earlier, I wasn't trying to hint that you need surgery or anything like that. I only mentioned surgery as a precaution to you so that if/when you see some doctors about fixing your knee, that you tread cautiously if/when they suggest surgery, and make sure you educate yourself and also get quality opinions before jumping into any surgery.

I'm sure my husband would just love for me to have another hobby that costs $$. At least when I played sports, basketball and soccer gear was cheap. I've since replaced my sports activities with photography, bowling, and a penchant towards gadgetry and some of that stuff ain't cheap, LOL.
« Last Edit: March 24, 2010, 02:40:08 AM by crankerchick »
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline crankerchick

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1863
  • Liked: 26
  • How 'bout them Cowboys!
    • Derotation osteotomy & TTT Post-op diary
Re: Knee Chondromalacia
« Reply #7 on: March 24, 2010, 03:03:27 AM »
oh yeah, even in my long-windedness i still forgot something.

doing the exercises you mentioned are good. i would add:

lunges
step-up/step downs

The icing is helpful as is the nsaid for pain if it works for you.

Working with the aid of a physiotherapist for exercises targeting the VMO (the inner part of the quad) would likely also be something to consider.

All my old doctors sent me to pt and the exercises you mentioned and I added are what they had me doing.

Also stretching the knee to chest on your back and heel to butt on your stomach along with stretching your hamstring and calves is good.

I think the exercises to avoid are full squats and leg extension with weights, but hey to each his own, if you can do them without pain then why not.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline crankerchick

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1863
  • Liked: 26
  • How 'bout them Cowboys!
    • Derotation osteotomy & TTT Post-op diary
Re: Knee Chondromalacia
« Reply #8 on: March 25, 2010, 06:17:19 PM »
So today i met another person who does MX. LOL! He says a person doesn't have to be in great shape to ride dirtbikes for fun, and its a good way to motivate a person to get back into shape.

The bike you shared looks so cool, but i would have to do some major saving up to buy a toy like that. LOL. That bike costs like how much I owe on my car now. I guess I could sell the car and just ride the dirt bike...

Of course I don't know a thing about dirtbikes, but me and my friend are going to watch some people ride this summer, so who knows :-)

Glad to see that you popped in over at TT too.

Good luck with PT. Hopefully it improves things for you!
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline motopayton

  • MICROgeek (<20 posts)
  • *
  • Posts: 5
  • Liked: 0
Re: Knee Chondromalacia
« Reply #9 on: September 03, 2010, 04:39:12 AM »
It has been a few years but I finally got an MRI for my knee

Here are the results and some images.

The doctor gave me two options... More physical therapy or undergo surgery in attempt to smooth out the cartilage which could potentially provide pain relief for an unknown amount of time. Somewhere between (0-5years)

This is the write up my doctor gave me

Procedure: MRI Left knee

Impressions

1. Negative for derangement of ligaments or menisci. The patient has a moderate joint effusion with some patellofemoral
chondromalacia affecting the medial patellar facet.
2. A tiny focus of bone or edema is present in the extreme medial aspect of the medial femoral condyle. Less than 1cm in diamater


Technique: The patient is studied on the Siemens Symphony 1.5 Tesla short bore magnet. Scan sequences include sagittal proton
density and T2 weighted turbo spin echo scans, coronal proton density and fat supresssed T2 weighted scans, and axial MEDIC
scans. Meniscograms are also produced.

Discussion: A moderate joint effusion is present in the suprapatellar pouch.

Bone marrow demonstrates a small focus of edema at the extreme medial corner of the medial femoral condyle.
Overlaying articular cartilage at that point is not well depicted here. This may represent a small bone contusion.

The cruciate ligaments are intact. Medial and lateral collateral ligaments are intact. Patellar tendon and quadriceps
tendon appear normal.

The medial meniscus is normal

The lateral meniscus is normal

Free edge of both menisci are sharply defined.

The axial images show some fraying of ariticular cartilage at the extreme medial margin of the medial patellar facet,
suggesting chondromalacia patella of grade 2 severity. There is no other evidence of a patellar dislocation or other
chondromalacia. The femortibial joints actually appear fairly well preserved.














http://s603.photobucket.com/albums/tt113/KtmPayton/?action=view&current=DSCN7946.jpg&newest=1
Click this for larger pictures
« Last Edit: September 03, 2010, 04:45:18 AM by motopayton »

Offline xBRUISERx

  • MICROgeek (<20 posts)
  • *
  • Posts: 8
  • Liked: 0
Re: Knee Chondromalacia
« Reply #10 on: September 05, 2010, 08:27:42 PM »
i discovered on my own,stiff legged dead lifts with weights are the best hamstring stretch for your knee's and wear a knee brace for compression. those two things helped tremendously.