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Author Topic: Activity after a chondral lesion  (Read 1632 times)

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Offline tobypaw

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Activity after a chondral lesion
« on: October 31, 2011, 09:27:02 PM »
I recently had exploritory arthroscopic surgery for a chondral defect that measures around 1.5cm. It is on my lateral trochlear surface. I had the scope, clean up the cartilage and 2 loose bodies removed. My other/next option is Microfracture. The surgeon didn't think that plugs would work well due to the adjacent patella being worn down also. My knee is still recovering, feels weak but I have very little pain. The crunchy sound in my knee is reduced but not gone. I'm in PT 3 times per week and that is going well. The OS suggests we wait at least 6 weeks to see how this surgery helped before making a decision regarding Microfracture. He couldn't give me a direct answer when I asked what would happen if I just leave this alone, I am concerned that it will get bigger and then I won't have so many options. My goal is to get back to swimming, biking and Yoga. I have ran for almost 30 years and don't feel the need to run long distance any more. I just want to be healthy and active.
Anyone else still moving about on a chondral lesion/defect? I see lots of Microfracture posts but not much about those who are still able to be active despite the chondral injury.
TIA :-)   

Offline vickster

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Re: Activity after a chondral lesion
« Reply #1 on: October 31, 2011, 09:37:35 PM »
I have a 1.5cm2 chondral defect on my lateral femur caused by a fall 2 years ago - the hole is on a WB surface and filled with fibrocartilage (as a result of the trauma, no microfracture needed here!)  I also have extensive grade 2 softening on the opposite tibia surface and a missing bit of lateral meniscus (torn in the same accident) plus knock knees to boot (I also had a successful chondroplasty of grade III W&T on my lateral patella at the same time as the menisctomy, all clean and tidy 9 months later)!  I was assessed for cartilage repair (MACI) last December, but due to the knock knees, I was given limited chance of success, and I would need a femoral osteotomy to correct the wonkiness, no thanks while I am largely pain free and can function  :) 

I am perfectly able to cycle (lack of general fitness and time has restricted me to 20 miles mostly, I have done 42 though), I can use the gym (time permitting), swim (crawl), walk.  Running, probably not, but to be fair, I don't have any desire to do so, never have done, so haven't tried properly. 

I see my physio occasionally for my knee, but all is fine.  I have tennis elbow at the moment (from cycling  ::) ) which is more of an issue right now!

There are many on here who are far more active than me, but my knee is no longer disabling... long may it last

Good luck :)
« Last Edit: October 31, 2011, 09:42:14 PM by Vickster »
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline aaa

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Re: Activity after a chondral lesion
« Reply #2 on: October 31, 2011, 09:39:10 PM »
I think its important to figure out why the wear / tear has happened on the lateral surface of the patella and trochlear surface.  The patellofemoral boards here have some good posts about proper diagnosis for patellofemoral issues.

I had grade II changes on my patella, I was fine until my kneecap dislocated from someone knocking it out of place. I'm now due for an MPFL reconstruction.  That should stop the maltracking and hopefully prevent further wear and maltracking on my kneecap.

But of course, surgery is not always the answer.  Possibly the PT will work for you.  What does your PT involve?

Offline tobypaw

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Re: Activity after a chondral lesion
« Reply #3 on: October 31, 2011, 10:08:09 PM »
I think its important to figure out why the wear / tear has happened on the lateral surface of the patella and trochlear surface.  The patellofemoral boards here have some good posts about proper diagnosis for patellofemoral issues.

I had grade II changes on my patella, I was fine until my kneecap dislocated from someone knocking it out of place. I'm now due for an MPFL reconstruction.  That should stop the maltracking and hopefully prevent further wear and maltracking on my kneecap.

But of course, surgery is not always the answer.  Possibly the PT will work for you.  What does your PT involve?

It is such a focal lesion with good stuff all around that the OS believes that I injured it in a bike crash. In talking with my PT, he did say that if I keep my IT band stretched and my patella tracking correctly, it is less likely to bother me.
I am still doing ROM stuff, stretching and some quad firing EXs. Will move onto other stuff in a few weeks. My leg is very weak and tight because for 2 months prior to surgery, I was limping pretty bad. The loose body would get caught in my knee and was causing pain and swelling. I know I have a long ways to go.

Offline Lottiefox

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Re: Activity after a chondral lesion
« Reply #4 on: October 31, 2011, 10:18:04 PM »
I have multiple lesions that have not had surgery. Some from a badly tracking patella and one from a pivot/sprint injury on my femur. I function pretty well. I can't run as it hurts but I can live with other exercise. I spin, weight train, yoga, pilates, can hike (apart from surgery on my foot but thats another issue!), can squat, can do some limited impact work like star jumps but I can't lunge without pain arising and I do have a LOT of crunching. I have had a lot of relief from Euflexxa injections but they tend to work on more generalised wear and tear, although they can help general lubrication so are sometimes worth a go.

No one can say how much you'll be able to do but do give it time. I was really badly off for about a year after my femoral chunk fell off and my kneecaps were so inflamed. Take you time and see how things go. People often have lesions and they don't even know until something troubles the site. Hopefully you'll get enough strength back to cope - keep us posted

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 tobypaw

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Re: Activity after a chondral lesion
« Reply #5 on: November 01, 2011, 12:42:59 PM »
Thanks for the replies. It's good to know that there is hope. I know I have a long way to go as I have lost a lot of leg strength but I miss my active life! 















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