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Author Topic: Grade 3-4 Chondral Lesion  (Read 5187 times)

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Offline Trev67

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Grade 3-4 Chondral Lesion
« on: December 15, 2010, 01:58:22 AM »
Hello all, new to this forum so appologies if this is posted in the wrong area.
I have been diagnosed with a Grade 3 - 4 Chondral Lesion in the mid to upper portion of the patellar apex with a small flap at the medial margin of this lesion. Mild patellar tilt is also noted as was arthritis and a bakers cyst. Have had Physio for 3 months with no improvement. My Surgeon informs me Chondroplasty will assist with easing the pain that i have in my knee as well as a general clean out.
(The pain is mostly felt when ascending / descending stairs and running)
He also indicated 2-3 weeks out of action and the procedure would take approx 40mins and that i would leave hospital with no brace, no crutches etc
Forgive me, but i feel a little sceptical about this after reading various threads and i kind of get the feeling that there is a little more to it.

Have any of you had this same condition?? Im trying to get an idea on what the PostOp side of things will be like??
Reason i ask is i have had a previous shoulder reconstruction due to a type 2 slap tear and at the time the surgeon said 4 -6 weeks off however i was actually off for 9 weeks and not back in sport until after 5 months.
Would love to hear from anyone if they have had the same condition and how their surgery went, and more importantly, post op / rehab

Cheers



Offline mictim

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Re: Grade 3-4 Chondral Lesion
« Reply #1 on: December 15, 2010, 03:33:50 AM »
Hello, I had an arthroscopy 6 weeks ago in which i was found to have grade 4 changes and grade 2-3 in other places along with plica removal scar tissur removal synovectomy and i had shaving of lateral and mediaql meniscus and chondroplasty in 3 pllaces ! I went home on  crutches and was on them for 2 weeks and off and on depending on my activity i had terrible pan the most painful arthrocopy i have had yet this was my fourth ! Each arthroscopy is different mri does not always show evertything so sometimes some more surgeri needs to be done than first thought ! it is really hard to say how you wil feel i have always been on crutches after each arthroscopy the first one i has wasn;t to bad off crutches in 4 days ! how you feel will depend what is found and what they do , best of luck to you !
,
2000 Left and rt knee arthroscopies, chondroplasty chondromalacia & chondyle defect
3/17/2010 rt knee arthroscopy  chondroplasty, synovectomy
11/3/2010 lt knee arthroscopy,chondroplasty 3 sites,pica and scar tissue removed,lateral&medail meniscus tears,synovectomy grae 4 chondromalacia patela

Offline Lottiefox

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Re: Grade 3-4 Chondral Lesion
« Reply #2 on: December 15, 2010, 07:20:08 PM »
With Grade 3-4 damage there isn't a massive amount to do apart from try and seal the edges and make the rough bits less rough. The idea is to smooth the surface of the worn out parts and help the knee function. But you might still have pain on stairs, if the damage is in an area that takes weight, shaving it to make it smoother won't adjust the pain on weight bearing if its grade 3/4. Washing out the crud and debris might help reduce inflammation, but it is a temporary measure. If you have tilt, be aware that sometimes surgeons get a bit chop happy once they go into the knee and start doing things like a lateral release.....be very clear if you want such a thing doing as that shifts the recovery along with the dynamics of the knee.

Personally, I have Grade 3-4 damage in most of my patella(s). In fact, given the size of the damage on a T2 MRI scan i don't think much of my patella has cartilage left! I found more relief with PROPER physio (took a good 6 months to have an effect), decent NSAIDs (Celebrex kicked my inflammatiion into touch and I take one very rarely now) and shifting to non impact exercise (spinning, biking, etc etc). They aren't perfect but they get me by just fine now so long as I don't attempt steep stairs carrying the hoover!

Surgeons will always tell you that a scope should ease pain. Its what they do. They are surgeons. And very often, they are right. But everyone recovers differently and you might have a dramatic difference, a slight difference, or none at all. With arthritis its a palliative measure rather than a cure.

Good luck with whatever you decide

Lottie
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline Trev67

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Re: Grade 3-4 Chondral Lesion
« Reply #3 on: December 15, 2010, 08:44:46 PM »
Hi Lottie & mictim, thank you both for your feedback. Its much appreciated.
My surgery is booked for Feb 2011 so guess will now just have to wait and see. I do have some questions for the surgeon on the day and one of them was the lateral release that you mentioned Lottie. I have read about them across multiple threads. To be honest, im putting a lot of trust in the surgeon to do what he thinks is best to achieve the best outcome so if he needs to do something like that well im happy for him to proceed. I told him that on my last consult.

I have tried 2 different physio's now and a course of celebrex. Would have to say the celebrex didnt do too much, physio has helped however sometimes i get the feeling that im wasting my time with physio (14 visits so far)  as one day it will be feeling good and the next im looking for ice packs etc as its aching.
Hopefully getting rid of any debris and trimming things up may help settle it to a level thats tolerable. I expect to feel a little pain and thats expected as i really enjoy sports and when playing high impact sports over the years i guess you have to expect something in your elder years. I originally injured it playing baseball a few years ago. Its only now really playing up as i aggrevated it again so time to get something done about it. Will keep an eye on the posts and will update with how things go.
All the best!
Trev


 

Offline crymouth

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Re: Grade 3-4 Chondral Lesion
« Reply #4 on: March 15, 2014, 08:12:26 PM »
Trev - Did you ever have the chondroplasty?  Did it help?
Five years old - First dislocation
'05 - scope, loose body removal, mild meniscus repair  (after a bad rt knee dislocation)
'13 - last dislocation
Feb 21 '14 - TTO and MPFL Reconstruction (Rt knee)