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Author Topic: chondromalacia advice needed  (Read 1436 times)

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Offline akurl

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chondromalacia advice needed
« on: August 12, 2012, 04:39:31 AM »
I'm a newbie, and looking for some knee advice as I prepare for my ortho consult later this week.

A quick background: I'm a 36yo female, very active, and have been experiencing knee pain and creaking/cracking off and on for about a year. There wasn't a particular injury or insult to it that I'm aware of. I can still fully participate in exercise, as it's not terribly painful or limiting- it just aches later on and is REALLY crepitus (sounds like I'm walking through the woods, breaking sticks). I've been avoiding certain exercise routines that I typically enjoy (like running and zumba), and have taken up activities like "aqua tone" to try to strengthen without further exacerbating. I ice it 1-2 times a day (especially after exercise), and I take an anti-inflammatory and glucosamine & chondroitin twice daily.

The diagnosis from the MRI is:
"thinning of the articular cartilage in the lateral compartment, prepatellar subcutaneous edema, focal moderate chondromalacia at the apex and some thinning of the prepatella cartilage along the media facet, mild joint effusion." All tendons and ligaments are intact, no meniscal tear, no popiteal cyst.

So my question is:
What does treatment for this diagnosis typically look like? How about the outcome?
Is this something that's usually chronic and a precursor to osteoarthritis, or can I expect to fully rehab it (and eventually run a 1/2 marathon or marathon)?

Also, can anyone help recommend a good knee doctor? I'm in Lancaster county, PA.

Thanks in advance for any input!!

Offline silverghost

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Re: chondromalacia advice needed
« Reply #1 on: August 12, 2012, 08:39:26 AM »
Hi

Sounds like you've been really busy!! I mean active.. Running obviously puts pressure on the knee joints and obviously as we get older the joints don't move as well as we would like and circulation decreases..Some creaking and cracking is normal but obviously you were worried so have changed activities to suit this. 

I think in life some people can go their whole lives running and sporting and have no knee problems (or back) at all.  Others have constant knee problems throughout.  This could be a wake up call for you to slow to different sports a kind of 'hey you there' from your knees!!

You could try getting some steroid injections to keep the joint moving for now and see how it goes but just bear in mind the cartilage wear further strenuous exercise will impact greatly on this and you want to try to avoid surgery if you don't have too..  Obviously only a consultant can advise you on what you should/shouldn't do so get some advice from him in conjunction with your MRI scans although I think he may say the same about the running!!

'96 ACL reconstruction
'09 Arthroscopy/cartilage repair
Diagnosed with Grade 4 OA no medial cartilage and significant varus alignment
'11 fitted with off loading knee brace
'12 HTO, meniscus transplant, acl reconstruction & microfracture all in 1 go!

Offline Maverick

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Re: chondromalacia advice needed
« Reply #2 on: August 13, 2012, 02:31:08 AM »
Akurl, I was diagnoised with grade 1 lateral chondromalacia of the lateral facet of the patella back in 2007.  Some of the time it does not bother me other times it does.  There are two things that seem to help the most.  First, my PT showed me how to tape my patella with kinesio tape to help the patella track properly.  You can look up You Tube videos on how to do this.  The other is strengtheing my quad and VMO muscles.

I hope that this helps you.
1976 Arthoscopy, damaged cartilage
2007 Lateral release of the patella
2011 Meniscectomy and microfracture (grade 4)
2012 Debridement / Chondroplasty
2013 CRPS left knee

Thank you, Maverick

Offline akurl

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Re: chondromalacia advice needed
« Reply #3 on: August 17, 2012, 04:02:53 AM »
thanks for the responses.

i saw the ortho today, and it turns out that the greater problem is a malformed patella (media facet is WAY smaller than lateral facet, causing the patella to pull laterally). cartilage under the smaller facet is pretty worn and broken up. surgery is not recommended at this time, but the problem is definitely chronic, and will likely happen with my left knee as well. bummer.

i now have a j-brace to wear most of the day for a while, and bought new running shoes (with pronation correction). i have an appointment with a PT for kinesio taping and VMO exercises. follow up in 6 weeks.

anyone have any luck running with chronic knee problems?















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