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Author Topic: Chondral defect in the trochlear Groove  (Read 1887 times)

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Offline spartanswimmer

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Chondral defect in the trochlear Groove
« on: February 02, 2012, 02:44:08 PM »
Hello, everyone...I was recently diagnosed with a stage 1 chondral defect in my trochlear groove. It is 1.5 cm. I started having pain right after Christmas while I was running. Was training for an ultra marathon. I took a week off, it felt better, I ran a 31 mile race, and it hasn't been the same since. It was suspected that I had torn my meniscus, but MRI confirmed it was a chondral defect. I'm devestated. I have no idea how I even got it. Does anyone have experience with these, and does anyone have a success story? I caught mine early, so I am on 12 weeks no activity in hopes it will fill with fibrocartilage. I'm praying it does, because I am terrified to have the surgery. I have searched and searched on the internet, and can't find a lot of information. It doesn't seem like there are a lot of runners with a chondral defect in my location, and all of the ones I read about are more severe. The doctor seemed to think it was a positive that it was located in the trochlear groove, because it would have a better chance to heal. It doesn't hurt to walk...only to run. I have so many questions though. Did I cause this by overtraining? I was only doing 60 miles a week (tops). Is there not a lot of information out there because people with stage one defects don't typically need sugery? What are the chances mine will heal on its own? Will I ever be able to run long distances again? If I dug a hole into my knee from running before, and fibrocartilage is not as strong, it seems as though running again is out of the question. I'm devestated because ultramarathoning is my passion. Any suggestions/advice would be welcomed. Thanks!



Offline mmrocker13

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Re: Chondral defect in the trochlear Groove
« Reply #1 on: February 02, 2012, 03:26:35 PM »
I feel as if you are everywhere I am right now :-)

I've responded to your other posts, but I will also add here: have you had a full gait and muscle assessment done by a running-specific PT? If not, when you get back into it, definitely consider it. It could be that you just have a slight imbalance somewhere, and that is causing undue strain somewhere (i.e. friction).

There's a lot of ifs and maybes when it comes to this sort of stuff--some peopel run on defects of all grades--weight bearning and not--and hardly realize it. Others are crippled trying to just walk with a grade I lesion in a non-WB area. So it's hard to say specifically. Ditto with progression. You may run on it forever (with some good PT and core stuff), and it never gets worse. Or it could get worse in a year or ten. It may not bother you more than it does, and you can just adapt to the oain...or it may become too painful to tolerate. Lots of ifs and ors and all that jazz :-)
89: Pat. dislocation, lat. meniscus tear, femoral OCD lesion
89: debridement, chondroplasty, lateral partial menisectomy
02: partial lat. menisc., debride
02: mfx
09: subtotal menisc., debride, c'plasty
10: scope/debride
10: varus DFO
13: HWR
15: total menisc., debride, c'plasty, notchplasty

Offline spartanswimmer

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Re: Chondral defect in the trochlear Groove
« Reply #2 on: February 02, 2012, 04:20:42 PM »
Haha- thank you for all your feedback! I posted in every forum that came up when I googled my injury. Guess you might say I am a bit desperate for information. I have been a long distance runner for about 20 years, and used to do way more mileage than I run now, so it is odd to me that this happened all of a sudden. I guess that's why I'm having such a hard time...I want to know why things happen, and I hate that I don't know. I have a very efficient form- it's been called "shuffling" before (which I hate) and I don't have a lot of bounce. That doesn't mean I don't have something wrong with my strike, though. My boyfriend, who is actually a physical therapist, thinks we may have caused this injury in the weight room. I take pride in having strong legs, and was showing him that I could do all the weight on the leg extension. I did it, and remember a slight pinch in my knee when I got off the machine. I shook it off and it was fine. I was in the middle of ultra-marathon training though, and ran lots of trails on it afterwards. I didn't have pain until a month later, which was when all this started. My boyfriend's theory is that I did the initial damage there, and then the long running is what actually caused the pain, because the bones showed signs of edema in the MRI.  The most times I feel my knee are when I use my good leg on the heel of my bad leg's shoe, and pull my leg out (to take off the shoe), and putting my leg up on a counter and extending it out. That goes along with leg extension, so I guess that makes the most sense to me as to how I injured it, but not sure that is the case. The doctor said the MRI showed that the defect was trying to heal, so I'm really praying it will continue to do it with 12 weeks rest. The unknown is what is driving me crazy. Can I at least do marathons again? Am I going to have to have surgery? I wish there was more documentation of stage 1 defects. All the ones I find are worse than mine. I want to know if conservative treatment should even be an optoin.It's so overwhelming :(

Offline mmrocker13

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Re: Chondral defect in the trochlear Groove
« Reply #3 on: February 03, 2012, 03:42:52 AM »
The reason that there's not much out there about grade I lesions is GOOD... there's not much there, b/c most respond to conservative therapy. When there's not much literature, it's either b/c there's not much to worry about, or b/c you've gone and done something not many folks end up doing :p You fall squarely into the former.

You're already responding to rest. Take some time to have a gait and strength assessment done when you come back...find out exactly where your weak spots are, and work them. Then, come back SLOWLY to running. So slowly, you think the end will never be in sight ;-) If the rest and PT fail, and you can't live with the pain, look into next line of treatment, like injections or a microfracture or some such (IOW, work with a doctor to assess yoru next steps.). :-)
89: Pat. dislocation, lat. meniscus tear, femoral OCD lesion
89: debridement, chondroplasty, lateral partial menisectomy
02: partial lat. menisc., debride
02: mfx
09: subtotal menisc., debride, c'plasty
10: scope/debride
10: varus DFO
13: HWR
15: total menisc., debride, c'plasty, notchplasty

Offline Miss Beams

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Re: Chondral defect in the trochlear Groove
« Reply #4 on: February 03, 2012, 09:19:57 AM »
Hi, in response to your post, i have a chondral defect in the trochlear groove, i blew my my MCL ligament causing large holes in the trochlear grove and the medial femoral condryle.  I had both mine microfractured 13mths ago(its been a long haul), anyway, i also have recurvatum of the knees (hypermoble) which hasn't helped, but i too found any excess bend forward going up and down sloping round catches etc, i also found that it would catch randomly when i turn etc.  I was also advised not to then and now put any excess strain on the patella (loading), no frog kick if i'm swimming and to take glucosomine supplements. I am still having niggles, have they suggested surgery???  Thinking back, i don't think i would have had surgery, i had a possible ACL rupture that proved to be intact albet i think it is lax so if that hadnt been a worry, i would have let nature take its course.  So i guess, if you leave it, it will prob settle its self, but will take a while :( and if you have the surgery that will also be a while for the clot to fully mature and it is not always deemed a success. I guess muscle and knee strengthening exercises  are a good start. i'm not a gym expert, but i am sure someone on this site will give you some better advice.
06/10  L knee trauma(horseriding accident) MCL
10/10 MRI ACL/MCL/G4CM/PF
12.01.2011 scope ACL intact, chronoplasty and 2 x microfractures FMC and trochlear ,MRI over reported(knee not as bad as made out),   time and patience will tell:)