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Author Topic: Can someone please tell me in laymans terms what this means?  (Read 9665 times)

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Offline Caggie

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Can someone please tell me in laymans terms what this means?
« on: August 10, 2012, 12:14:29 PM »
Hey all,

Just had another meniscectomy and the report from the surgeon says "lateral tibial plateau articular defect grade III' I'm taking anything that's grade 3 isn't good but not really sure if this refers to joint or cartilage or what? can anyone explain to me please?

Caggie
L/K lateral Meniscectomy 19/08/05
L/K lateral Meniscectomy 07/10/05
L/K Open lateral cyst excision 11/11/05
L/K lateral Meniscectomy  in 2007
L/K lateral Meniscectomy 03/08/12
L/K lateral Meniscectomy/Chondroplasty 25/04/16

Offline Kaputt_Knee

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Re: Can someone please tell me in laymans terms what this means?
« Reply #1 on: August 10, 2012, 12:34:35 PM »
It means he assesses you having a damaged section of articular cartilage and Grade III means it is relatively serious (the scale is from I to IV) in his opinion.

The question you need to ask is "Is it on a weight-bearing section?" and what does the surgeon think should be done.

It is always worth getting at least one more independent opinion before you decide to follow any particular action though. I was diagnosed as having Grade III to Grade IV damage to my left knee by one surgeon, Grade II to III by 2 others and finally by the guy who went in and sorted out the mess created by the first guy, "remarkably little arthritis considering the age and surgical history of the patient!"  ???  ::) So definitely a case of "buyer beware" before you commit to a particular course of action.

 ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline Caggie

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Re: Can someone please tell me in laymans terms what this means?
« Reply #2 on: August 10, 2012, 05:28:58 PM »
Thanks Kapput

Considering it also said I only have 50% cartilage left lateral side following all my surgeries I guess it would make sense.  The surgeon was originally very reluctant to even touch my knee despite me being in chronic pain for the last 4 months.  He also said there was no sign of arthritis under kneecap despite kneecap being a serious problem last few months.  I am waiting for post op check up in a few weeks when he says he has lots of photos to show me....I do not think i will have to commit to any other course of action cos quite frankly they don't wanna touch me .....i'm 34 by the way!  With this sort of degradation what can they do?

Caggie
L/K lateral Meniscectomy 19/08/05
L/K lateral Meniscectomy 07/10/05
L/K Open lateral cyst excision 11/11/05
L/K lateral Meniscectomy  in 2007
L/K lateral Meniscectomy 03/08/12
L/K lateral Meniscectomy/Chondroplasty 25/04/16

Offline Teacher2Many

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Re: Can someone please tell me in laymans terms what this means?
« Reply #3 on: August 10, 2012, 06:11:41 PM »
I had grade IV patella defects on both knees with about 70% of my cartilage missing at the time of the ACI surgery.  5 months prior when the scopes/biopsies were done, it was still grade IV but not that high of a percentage so needless to say, they got worse really fast.  They did bilateral ACI and both graft sites have taken and filled in completely.  There are other options available (ACI, OATS, etc.) so ask a lot of questions and always get a second opinion-preferably by someone who specializes in treating cartilage defects.

Best of luck in your quest for pain free knee(s)!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Vickster

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Re: Can someone please tell me in laymans terms what this means?
« Reply #4 on: August 10, 2012, 07:13:03 PM »
The arthritis section on here is very good at explaining what it all means and how it can be treated - starts here  http://www.kneeguru.co.uk/KNEEnotes/node/1846

This is quite helpful too, providing the grading

or Wiki...

The International Cartilage Repair Society has set up an arthroscopic grading system by which cartilage defects can be ranked:

    grade 0: (normal) healthy cartilage
    grade 1: the cartilage has a soft spot or blisters
    grade 2: minor tears visible in the cartilage
    grade 3: lesions have deep crevices (more than 50% of cartilage layer)
    grade 4: the cartilage tear exposes the underlying (subchronal) bone


Depending on what country you are in, it may be worth seeking out a further opinion from a knee surgeon with a special interest in cartilage as mentioned.  Articular cartilage itself doesn't have nerve endings, the pain usually comes from the bone below.  Repairs can be done, or depending on the alignment of the bones, an osteotomy can help by shifting the forces within the joint

Good luck with finding a solution :)



Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up