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Author Topic: fissure in trochlea  (Read 1064 times)

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Offline Kolonelgreen

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fissure in trochlea
« on: December 28, 2015, 06:57:10 PM »
Hi everyone I've just joined as I recently had an arthroscopy on my left knee. The results showed and I quote "a very angry synovium, Gr IV fissure in trochlea, Gr II changes on MFC." What does this mean? How is it there is no offer of treatment? I hope someone can help me thank you.

Offline Vickster

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Re: fissure in trochlea
« Reply #1 on: December 28, 2015, 07:57:03 PM »
What was the reason for the arthroscopy? Pain or mechanical issues or both? Did you sustain a trauma to the knee? How old are you? Activities? Sport?

Unfortunately, grade 4 means the bone is exposed through the articular cartilage that covers the bones (the trochlea is the groove the kneecap sits in). The fact it is referred to as a fissure means it's probably a small area that doesn't warrant the trauma (and cost) associated with repair / transplantation

Grade 2 on the medial femoral condyle means there is some softening but the bone is still protected.

In the learning hub, there's really good info in the primers on knee anatomy and joint cartilage/arthritis

I expect the angry synovium is the cause of the pain, rest might help it settle.  There could also be bone marrow oedema (bone bruising) under the cartilage damage, this causes pain and can take a very long time to heal.  You could ask the surgeon about injections of platelet rich plasma (PRP) to reduce inflammation and aid healing

Depending on your country, you could also discuss stem cell injections, early days but results have been promising (can be very expensive though), it could help with inflammation and settle everything

Good luck, unfortunately articular cartilage damage is very hard to treat and manage. You may wish to consider the types of sport and activity in which you engage even once the knee has recovered from the surgery



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

Offline Kolonelgreen

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Re: fissure in trochlea
« Reply #2 on: December 28, 2015, 09:50:24 PM »
Hi vickster and thank you so much for your informative reply.
I had my arthroscopy after long term pain and swelling for the past three months. I've never had a trauma to my knee however I have always had issues with my knees in fact in 2010 I had a grade 3 tear that required an arthroscopy to remove.
My concern is that although they did the arthroscopy no surgery was carried out to rectify the problem so would I be right in presuming my pain will be ongoing and swelling will still be present. I am only 42 and my job requires a lot of kneeling down hence my concerns? Thanks again.

Offline Vickster

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Re: fissure in trochlea
« Reply #3 on: December 28, 2015, 09:58:13 PM »
A grade 3 tear of what was removed? Meniscus? If so that could explain the arthritic changes, especially of the MFC, often a consequence of meniscus removal, I.e, the shock absorber between the bones

Perhaps ask your surgeon about injections of PRP or hyaluronic acid to help with the inflammation

If kneeling a lot for work, try to use knee pads whenever possible. If that damage to the MFC is on a weight breathing surface, it'll hurt and get inflamed when kneeling on it

There's not really an easy fix to the issues you have, especially if they are down to wear and tear
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

Offline Kolonelgreen

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Re: fissure in trochlea
« Reply #4 on: December 28, 2015, 10:11:23 PM »
Yes it was a grade 3 tear of my cartlidge. So am I right in thinking that I will have to resort to taking stronger pain killers or a cortisone injection of some kind to ease the continual pain? Thanks again.

Offline Vickster

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Re: fissure in trochlea
« Reply #5 on: December 28, 2015, 10:48:01 PM »
Cortisone doesn't offer long term relief and can damage the tissues in the joint. PRP does the same sort of job, but is natural being produced from your own blood

Also, use ice packs daily to help with the swelling and keep the knee elevated whenever you can too

Perhaps talk to your physio about exercises to strengthen and balance the knee or even some sort of support to off load the damage

Unfortunately, with meniscus gone, the damage may get worse depending on how much was removed (I don't know what grade 3 means with regard to meniscus?)
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

Offline Kolonelgreen

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Re: fissure in trochlea
« Reply #6 on: December 28, 2015, 10:55:25 PM »
Thank you so much for all your help and advice. I await an arthroscopy on my right knee now take care and thanks again

Offline Vickster

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Re: fissure in trochlea
« Reply #7 on: December 28, 2015, 11:02:38 PM »
Exhaust all conservative routes, physio, injections etc before going the surgical route, keep that as a last resort

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















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