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Author Topic: Chondromalacia Patella + Patellar Tendinosis  (Read 34888 times)

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Offline papasmurf1978

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Re: Chondromalacia Patella Pain
« Reply #45 on: August 12, 2014, 07:05:15 PM »
MDAL,

little of topic, would you be able to give me an idea if I have patellar tilt. I feel I do in the right knee, or could be that my lateral patellar retinaculum tendon is tight as I'm getting lateral patella pain, feels like it's in the tissue or something.

I posted my MRI's in:

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=64591.15

Thanks
August 2014 MRI:
Mild Chondromalacia Patella in both knees
Normal cartilage thickness in both knee caps

Offline MDAL

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Re: Chondromalacia Patella Pain
« Reply #46 on: August 12, 2014, 07:13:12 PM »
If you want we can trade, I will keep yours and you keep mine :)

MRIs need to be analysed by the entire range not just a single section, and obviously by an actual medical expert.

Just for the record, note that the lateral side is always smaller in space than the medial. That is how it is supposed to be, and often people panic when they see it.

Either way, compared to mine and many others I have seen around here, looks like you don't have much of an issue.


Offline papasmurf1978

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Re: Chondromalacia Patella Pain
« Reply #47 on: August 12, 2014, 07:40:09 PM »
Thanks MDAL,

appreciate your humor :) MRI report didn't state patellar tilt so I think it's probably just the tight tendon, will work on that. Just want go get grand scale of your knee damage? wanna share your story?
August 2014 MRI:
Mild Chondromalacia Patella in both knees
Normal cartilage thickness in both knee caps

Offline MDAL

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Re: Chondromalacia Patella Pain
« Reply #48 on: August 12, 2014, 08:14:45 PM »
I could, but that would keep me writing until Xmas...  ;)
« Last Edit: August 12, 2014, 08:16:20 PM by MDAL »

Offline vickster

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Re: Chondromalacia Patella Pain
« Reply #49 on: August 13, 2014, 09:05:53 AM »
MDAL is right about the MRI, the report is generated by looking at the hundreds of images, not just one in isolation.  You have the full report I think.  If you want more information, best to ask the specialist :)

My most recent MRI report referenced several images specifically for the items commented upon.  Anything that was fine (tendons and ligaments) was also noted
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 papasmurf1978

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Re: Chondromalacia Patella Pain
« Reply #50 on: August 13, 2014, 10:29:44 AM »
My question is, say a tendon is tight and putting pressure laterally on the patella, will that come up on the MRI? If there's no damage to the tendon only tightness.
August 2014 MRI:
Mild Chondromalacia Patella in both knees
Normal cartilage thickness in both knee caps

Offline MDAL

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Re: Chondromalacia Patella Pain
« Reply #51 on: August 13, 2014, 10:40:08 AM »
Hardly...

MRIs are very imprecise and results are done with a fair share of "interpretation". It may be possible to observe an inflammatory process that is causing that tendon or ligament to be tight, but no one in their right minds would put their hands on fire on an assumption.

The mechanical evaluation of such thing is always an opinion based formula. You go to 10 OSs and don't be surprised to obtain 10 distinct opinions, and so are the surgeries performed under such assumptions such as lateral releases or osteotomies which are calibrated by the eye and the results of such procedures are a bit like flipping a coin... work for some and create a big mess for others.

It's all an "opinion" based methodology.



Offline vickster

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Re: Chondromalacia Patella Pain
« Reply #52 on: August 13, 2014, 11:22:15 AM »
An ultrasound might show up issues with a tendon, the damage to the one in my elbow was clear to see for the OS, and then able to injection steroid into it and later PRP using the ultrasound to guide the needle

If the tendon isn't torn or badly damaged, with proper rest (no squats etc), ice, anti inflammatories and potentially a support, you might be able to get it to settle.  An inflamed tendon/other soft tissue could well be the culprit rather than the grade 1 cartilage softening
« Last Edit: August 13, 2014, 11:24:58 AM 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 papasmurf1978

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Re: Chondromalacia Patella Pain
« Reply #53 on: August 13, 2014, 03:43:55 PM »
I agree with you Vickster

I might have had the pain from the beginning from the tendon. It`s like a sore, sensitive and painful feeling I have in it. Since it`s on the lateral patella side, I don`t have pain in the knee cap but on the side since tendon is attached to it. Also, it`s quite stiff, I started to push the knee cap up laterally by pushing the medial side of it to get the tendon to stretch out a bit, it might`ve got tight when I was doing squats. Let`s see how it goes. I`m also icing religiously my knee.
August 2014 MRI:
Mild Chondromalacia Patella in both knees
Normal cartilage thickness in both knee caps

Offline vickster

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Re: Chondromalacia Patella Pain
« Reply #54 on: August 13, 2014, 04:10:18 PM »
Ask your doctor about steroid or PRP, may just give you the required anti inflammatory benefit.  Could also try slapping voltaren gel (assuming not taking oral anti inflammatories)

I don't know how tendons get tight, the one in my elbow got inflamed then it got ragged and gritty, not stiff
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 papasmurf1978

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Re: Chondromalacia Patella Pain
« Reply #55 on: August 13, 2014, 05:44:38 PM »
Vickster,

you mentioned something about some acid injections. What are they. Did they do any good for you
August 2014 MRI:
Mild Chondromalacia Patella in both knees
Normal cartilage thickness in both knee caps

Offline vickster

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Re: Chondromalacia Patella Pain
« Reply #56 on: August 13, 2014, 05:51:58 PM »
Hyaluronic acid - you can Google the details further

http://www.arthritisresearchuk.org/arthritis-information/drugs/hyaluronan.aspx 

They are indicated for mild-moderate arthritis I believe.  Several different brands - Synvisc, Orthovisc, Durolane, Ostenil, Euflexaa, probably others

You have to be careful if allergic to eggs as some are derived from poultry

Yes, they do seem to help me.  I had one in Dec 2010, another course of 3 in May 2012 and a single 'plus' injection in December 2013

They aren't especially painful as long as you are relaxed, although the knee can feel full and stiff for a bit.  They take about a month to have an effect, but it seems only 50% benefit, the indication is quite narrow according to my OS

« Last Edit: August 13, 2014, 05:54:40 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 papasmurf1978

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Re: Chondromalacia Patella Pain
« Reply #57 on: August 22, 2014, 01:33:05 PM »
Hi Vickster,

I'm thinking of getting Synvisc One injection in my knee. Do you think it's a good idea? Will it get rid of the little crunching I'm felling when bending knee sideways? I think it's crepitus or something.
August 2014 MRI:
Mild Chondromalacia Patella in both knees
Normal cartilage thickness in both knee caps

Offline vickster

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Re: Chondromalacia Patella Pain
« Reply #58 on: August 22, 2014, 02:57:38 PM »
I've not had Synvisc, only Durolane and Ostenil

You need to ask your orthopaedic specialist if it would be indicated for you - did you already?  HA is for moderate osteoarthritis where replacement not required, grades 2-4 I believe.  I have no medical qualifications and could not say if it's appropriate or not.  They are not without risks, so your doctor and you need to decide whether it's something needed.  Is there pain and swelling with the crunching, most knees make noise sometimes

If it's a tendon issue though, steroid might be more suitable or PRP
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 papasmurf1978

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Re: Chondromalacia Patella Pain
« Reply #59 on: August 22, 2014, 03:14:09 PM »
I think crunching is due to cartilage softening. No pain associated with knee bending. Also, it might be air pockets making the crunching noise. It doesn't do it if I bend my knee left only right. What is the risk of the injection? Also, is chondromalacia Grade I softening a precursor to Osteoarthritis?
August 2014 MRI:
Mild Chondromalacia Patella in both knees
Normal cartilage thickness in both knee caps