Chondromalacia Patella + Patellar Tendinosis

[vickster]

If concerned, check with your specialist   No one online can diagnose the issue.  A hyaluronic acid injection would help to lubricate the joint and perhaps alleviate the creaking

[papasmurf1978]

Just got my MRI results for both knees. It states that I have mild chondromalacia patella Grade I in both knees. So that would mean signs of softening. So this means it's not fissure or damage. I will post full results once I have them in english cause test was done in french. I was told that everyone will have chondromalacia patella in their lifetime, some will get faster as per accident or injury and some with regular wear and tear. I guess at my 36 years of age, getting it as grade I would be normal no?

[papasmurf1978]

Here's my MRI in french. If anyone can translate what it means:

IRM GENOU DROIT


Renseignements cliniques:

Syndrome fémoro-patellaire. Chondromalacie.

Technique:

Examen effectué selon le protocole standard.

Constatations:

1. Cartilages (classification de Outerbridge) :

Le cartilage patellaire est légèrement hétérogène centralement compatible avec une légère chondromalacie (grade I/IV) avec préservation d'une épaisseur normale. Le cartilage de la gorge trochléenne est dans les limites de la normale. Pas d'anomalie cartilagineuse fémoro-tibiale.

2. Ménisques :

Normaux. Pas d'évidence de déchirure.


3. Ligaments croisés et collatéraux :

Intacts.

4. Tendons et retinaculum patellaire :

Normaux.

5. Structures osseuses :

Normales.

6. Autres :

Pas d'épanchement. Pas de kyste poplité.

Opinion:

Légère chondromalacie patellaire.





IRM GENOU GAUCHE


Technique:

Examen effectué selon le protocole standard.

Constatations:

1. Cartilages (classification de Outerbridge) :

Légère hétérogénéité du cartilage patellaire médialement représentant de légers signes de chondromalacie (grade I/IV). Le cartilage rotulien conserve une épaisseur normale. Le cartilage de la gorge trochléenne est normale. Comme pour le genou droit, la gorge trochléenne a une morphologie normale sans dysplasie. Il n'y a pas de patella alta. Pas de séquelle d'ancienne luxation de la rotule. Le cartilage fémoro-tibial est normal.

2. Ménisques :

Normaux. Pas d'évidence de déchirure.

3. Ligaments croisés et collatéraux :

Intacts.

4. Tendons et retinaculum patellaire :

Aspect légèrement hétérogène et discrètement épaissi du tendon patellaire distal à son insertion sur la tubérosité tibiale antérieure. Les autres tendons sont sans particularité. Le retinaculum patellaire est normal.

5. Structures osseuses :

Normales.

6. Autres :

Pas d'épanchement. Pas de kyste poplité. Petite plica médio-patellaire.

Opinion:

Signe compatible avec une légère chondromalacie patellaire.
Légère tendinose patellaire distale. À corréler avec la clinique.

[vickster]

Mild patella chondromalacia in both knees. Mild patella tendinitis in the right. I'd be considering rest and prp, there's nothing surgical to be done. Good news

[papasmurf1978]

thanks Vickster,

What is prp? Ill stop doind squats for a while as the lateral side of my right patella hurts all the time

[vickster]

Platelet Rich Plasma

I wouldn't squat with patella issues, indeed I'd find another physio for a patella friendly rehab.  Maybe try swimming as a long impact activity, brawl, backstroke, no frog kick

Supported lunges, glute bridges, wall slides with go, all with good form might help your weak hip muscles too

[papasmurf1978]

Vickster,

I have a question. my left leg which has patellar tendinosis feels weird when i walk. Its like the patellar tendon is stiff and its compressing my patella a little and it just doesnt feel normal when i bend my knee backwards. Its like its stiff in the tendon. Any idesa?

[papasmurf1978]

Also does CP lead to arthritis?

[vickster]

Not necessarily no, arthritis is grade 4 bone on bone.  Age, wear and tear is the most common cause of arthritis,  not a lot any of us can do about that.   Being active (nourishing the cartilage with synovial fluid) and keeping weight optimal are good too

Have a read of the relevant primers in the info hub (arthritis and patella).  There are 4 grades of articular cartilage damage, 1 softening is the first but there is no guarantee it will progress or indeed not progress

http://www.kneeguru.co.uk/KNEEnotes/primers

http://www.kneeguru.co.uk/KNEEnotes/primers/patella-primer/what-chondromalacia

Reading about overuse injuries like patellar tendinitis may help too

Some supplements can help

[papasmurf1978]

Thanks ill check it out. Whats your opinion on sissy squats?

[vickster]

Don't know what they are.  I don't do any squatting, not suggested by physio or surgeon

[papasmurf1978]

Thanks Vickster,

Im wondering why my physio told me to continue with squats (with profer form) of course. I read few articles that encourage squatting for chondromalacia patella as it provides necessary pressure to get the bad stuff out and nourish cartilage with good stuff. Right now I stopped and am doing only wall sits with ball between legs to get my quads stronger. Also lots of stretching and icing the knee.

[vickster]

I can't say, maybe it is the right thing for you to do.  But didn't part of the issue come from doing squats, wrongly?  Unless you are being watched, I don't think you can ever be sure they are being done right, like a lot of physio exercises

What is the 'bad stuff' you refer to?  Activity is indeed important for synovial fluid as I understand it, but the right activity given the condition.  Cartilage starts to wear regardless as we age (probably from about age 30) and partly as there is lower lubrication in the joints, hence the use of the hyaluroic acid in arthritic knees, to mimic/encourage synovial fluid production.  Seems to work for me anyhow

[papasmurf1978]

I have to assume that my poor form lead me to my condition and when I did squats something went wrong. Then again everyone or almost everyone will get chondromalacia patella in their lifetime. Softening of the cartilage is something that will come with wear and tear. Unless you never move, you are prone to daily cartilage degeneration. Now that I was doing squats with proper form, my knee responded well. But i got freaked out when reading that squats are a big no no for chondromalacia patients. I will definitely get another physio to look at me and my situation. Weird thing is that I barely get any pain behind the knee cap like many of you out here but only lateral pain which is a sign of maltracking. And I do agree with what you said that there's no guarantee that it might or might not progress. I truly believe in reinforcing knees, especially quads will keep the knees in healthy state for years to come.

[vickster]

I had grade 3 crabmeat on my lateral patella that was tidied when I had my menisectomy, I was unaware of it, I don't believe it showed on MRI, although I didn't see the full report.  I don't know if it was caused in the accident or was already there.  I was 37 then (42 now).  I think my last MRI showed other wear to the patella but it still doesn't bother me specifically

Talk to your physio about your concerns (you evidently are worried if looking at surgical solutions overseas), your goals etc