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Author Topic: Now what???  (Read 620 times)

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Offline wturri78

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Now what???
« on: December 17, 2014, 09:54:41 PM »
Here's my basic issue...I have chondromalacia in both knees and first started having real pain on both sides about 18 months ago. I backed off running, did PT...things improved, but the soreness and stiffness after exercise never went away. So I stopped running for a time. Eventually the indoor cycle caused pain after exercise. Even total rest didn't improve anything. My knees are audibly louder than a year ago...I feel them grinding and popping when doing a deep squat. And I'm at a crossroads.

MRIs from 12 months ago showed cartilage wear and some "near full thickness fissures." I feel worse than at the time of the scans...no idea if things have physically degraded further.

Here's what's been done so far.

1. Various PT routines...over a year...I have way stronger quads, glutes and hips! But little improvement in knees.
2. Cortisone injections...twice, 6 months apart...wonderful relief! For 5 days at a time  >:(
3. Orthodvisc...3 injections, 1 week apart, last shot was 4 weeks ago...not even a hint of improvement.

One ortho said the next step probably would be arthroscopic "cleanup" though he was pessimistic as to how helpful it would be, since there are no clear "hanging flaps" or bone spurs to remove.

Another ortho offers PRP and stem cell therapy (using the Regenexx method). Recommends that as the next move. Claims he's seen 80% success over the 3 years he's done it. I'm dubious because even if it does really help, there's no long-term data, it's too new. Plus, no insurance coverage = $5K or more per knee. That's a boatload of money to spend on something that may be a waste of time! (He thinks stem cell plus PRP as a "booster" is best...PRP by itself, he's not keen on)

Yet another doctor recommends prolotherapy...says it has helped others like me...but might take anywhere from 7-10 sessions per knee!!!!!! Other people think prolotherapy is voodoo and at any rate, I don't see how sugar-water can regrow cartilage! At least there's some reasonable theoretical basis behind stem cells.

So...what the heck to do next? What would YOU do in my situation? The pain is livable...for now...I'm only 37...I'm already getting "side effects" of knee pain on my overall health, i.e. weight gain from less exercise, sore back from not lifting properly, cuz my knees hurt...

HELP!  :-\

Offline Vickster

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Re: Now what???
« Reply #1 on: December 17, 2014, 10:32:44 PM »
Have you had full X Ray and CT imaging to confirm the cause of the cartilage damage - i.e. are your kneecaps tracking correctly?  Have you gone back to basics with the physiotherapist to ensure thay all the muscles in your legs, knees, hips, ITB etc are working as they should in a balanced way, and to stop any issues getting worse elsewhere?  Are the tendons clean and ligaments in tact? 

The evidence for relieving PFPS with arthroscopic clean up is hit and miss and can make things worse

Good luck :)
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