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Author Topic: Chondromalacia patella, advanced to full-thickness lesions: options?  (Read 1247 times)

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Offline hephaestus

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Hi everyone--

I've had chondromalacia with mild symptoms for some time, and after a serious recent injury, the lingering pain and swelling sent me back to the ortho, who MRI'd the knee and found at least one deep pothole in the cartilage on the patella, with bone swelling underneath it.

I've had LOTS of physical therapy, and a lateral release, and things still got to this point. So now, two surgeons want to perform cartilage repair, and a third wants to be conservative with injections first.

If I leave the condition alone, or just treat the symptoms, is it true that I'm allowing the cartilage to degenerate further? I'd try the injections if they somehow froze the damage in time, but I suspect that they can't cushion the joint sufficiently, so the uneven pressure on the ragged edges of the pothole(s?) is going to continue to cause degeneration. Does anyone have insight into this? Do any of the palliative or time-buying treatments arrest the damage, or are you only using them to mask symptoms as you continue to move toward possible future knee replacement?

I'd love to try cartilage repair, but the odds seem so sketchy (especially for the patella), and the procedures are so new.

The constant aching has really gotten me down, and the feeling that every step I take is doing more damage really isn't making things better...thanks for any knowledge you can share!!

Offline Adobec

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Re: Chondromalacia patella, advanced to full-thickness lesions: options?
« Reply #1 on: January 10, 2013, 04:38:54 AM »
I don't know the answers to most of your questions,unfortunately.  I actuall had the same questions back in the day :)

I did have microfracture of the femoral trochlea in march 2012 and when I had my TTT the following November, the pothole had completely filled in.  So there is hope!
1991 - R ACL patellar tendon, med. meniscus removed (50%)
2002 - R ACL revision, cadaver, lat. meniscus removed (50%)
2011 - L ACL patellar tendon, med. and lat. meniscus REPAIR. 
3/2012 - L Medial meniscectomy (didn't heal from 2011), microfracture
11/6/12  - L TTT (maquet). Micro fully healed