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Author Topic: 4-1/2 months post ACL recon - basal delamination of cartilage  (Read 526 times)

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Offline Windingworm

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4-1/2 months post ACL recon - basal delamination of cartilage
« on: December 10, 2015, 06:34:54 AM »
Hi everyone,

I'm new here and got my ACL recon done 4 and half months ago with hamstring autograft.

Everything is going fine, I started running about a month ago and my PT is very happy with my progress.
I was just complaining about some random, deep clunking feeling coming from around my tibial plateau (not the kneecap), so my doc prescribed an MRI to make sure everything was fine.

I got the results yesterday.
It says that my graft is intact, my menisci are fine, and it seems that the clunking feeling that I have would be caused by some mild reactive fluids still stuck in my joints. Nothing to worry about then, it will just settle with time.

However, they found this on the MRI:

At the medial patellar facet and patellar apex, there is a focal area of cartilage softening and fraying involving a region measuring approximately 1.1 cm in size.
Some underlying basal delamination is seen at the opposing femoral throchlea groove involving a region measuring 1.0 cm in size.

I am very concerned about this basal delamination.
My doc said that he couldn't really do anything about it since the outer aspect of my cartilage in the throchlea groove is intact; it is at the base that there seems to be some very early detachment happening.
As the radiologist said himself: "we can see some subtle change of signal at the base of the throchlea groove which makes us suspect delamination. 5 years ago, we would have maybe not picked it up."
The doc asked me whether I perhaps pushed it too hard, like if I did 100s of squats per session but no, I definitely didn't over-train, I was way too busy for that.
And I feel no pain around the kneecap right now. I had some patellofemoral pain at the second month mark like most ACL reconstructed folks (which is why I'm not too surprised about the wearing of the kneecap), but it's long gone now, I can go up and down stairs with no prob at all.

The doc is also very elusive about this delamination condition.
He asked me to take it easy with my rehab until my quads get stronger and relieve some pressure off the patellofemoral joint. But how can my quads get stronger if I "take it easy"?
It doesn't make sense to me. I really don't think straight leg raises will help building more quads at this stage anyway.

Also, will this early stage delamination heal somehow?
Will I be able to run again without risking to have to my entire cartilage coming off?

All these are questions that are left unanswered for now.
I hope someone out there with some knowledge or a similar experience will give me some help...

Thank you.