Hurt my knee - Bone Bruise

[vickster]

Fingers crossed. That knee is pretty knackered but it's been pretty trouble free for a couple of years

Got an appointment with GP and physio on Thursday for shoulder so will ask about knee too if still playing up. Its weirdly worst behind the knee, I'm just assuming meniscus as I know I already have tears in there and the mechanism 

[tensters]

I'll keep my fingers crossed for you. Good that you may be getting it looked at right away. Hopefully its nothing serious.

[vickster]

Indeed. I start a new job on Monday!

Might try a gentle gym workout later, some light resistance on static bike and elliptical 

[tensters]

Sounds good. I think I am going to get a gym membership soon.

[vickster]

It's a good option for an evening workout especially for a fair weather daytime cyclist for me! Mine is really cheap too, probably equivalent to $25 a month, unlimited use...and 5 minutes from home 

[tensters]

Today went out with no ibuprofen and a very different experience. Got 1 block and was limping and not feeling good at all. Maybe was a little stressed from yesterday. Try again tomorrow.

[tensters]

Hi Vickster.

Hope your knee is doing ok. I started pt for the knee and knee is doing better.

[tensters]

So i started physical therapy and quit after just two sessions. The therapist not only kept putting me into lumbar extension which I told her I cannot do  due to spondylolisthesis (and I got the feeling she had no idea what that is - scary for a doctor of PT), she kept having me do things that were putting a lot of pressure on the bruise and hurting it. So I quit that.

I'm going to see back doc next week, have xray, hope all is okay - probably is - and ask him for some back PT at a good place I know. I'll also ask him if they can work in some cycling for the knee.

Knee is doing better. I can walk for 20 minutes and can do 6 flights of stairs up and down - slowly. I work at it everyday. Still not normal yet though and the bruise still hurts from time to time even when doing nothing but is getting better. My flexion is not full. I think a lot of my issues now are just dealing with all the muscle atrophy and lack of use.  Back is also totally stiff.

I guess as doc says it is going to take a while. I read a few posts online that people were dealing with this - a medial femoral bruise - a year later - unable to climb stairs after setbacks. Man I hope I can keep it improving.

Got the brace, don't like it at all. Its so bulky and heavy. I don't know how anyone can wear it - even with sweatpants its a tight fit. I might give it a try but I don't see myself wearing it much.

[tensters]

My knee is slowly but surely getting better. The bone bruise is hardly hurting at all now (it's been a little over 3 months since injury).

I'm slowly regaining my normal fast and long walking stride, and am getting better at descending stairs. Going upstairs is no problems. I have full extension and seem to have full flexion now. I bought a gym membership, and have just started to use the exercise bike a little. I'd say my knee is about 70% better. Maybe a little less.

Reading the MRI again, it mentions a 4mm osteochrondal lesion as part of the bone bruise description in the medial femoral condyle. I've read about this before and its a little confusing. I think what this means is the bone and articular cartilage have been damaged, and articular cartilage doesn't really regenerate/heal and just sort of scars over. This kind of injury in time can lead to osteoarthitis, persistent pain etc.

I've read there are various treatments, many of them involving surgery and casts etc. Also read that for many people these lesions are asymptomatic, which I assume means there is no pain or swelling from it or progression to OA. The lesions also seem to be common.

I'm trying to get an idea of how likely this could be an issue in my case. The knee seems to be doing well - no longer any pain or swelling just taking some time (a damn long time) to get back up to speed.

Is this type of injury really that common? Is it common among the types of bone bruises?
Would this be considered a relatively small injury at 4mm? I ask because I've read of surgeries and they all seem to involve much larger (cm) lesions.

The orthopedic surgeon when I saw him last did not seem to think the injury was a big deal just that bruise might take a while to heal due to its location.

[vickster]

4mm is tiny when you think about the size of the bone surface.  I'm surprised they even mentioned it. I can't imagine it'll cause you any great issue. 90% of the adult population probably have some sort of flaw somewhere on a bone.  I can't imagine why you'd consider surgery? And what would a cast do?

I'm not minimising it, but really I wouldn't worry about it, as you say the pain is gone, the knee is nearly better if your surgeon isn't concerned and it's causing you no specific trouble, move on, forget about it. Focus on other more important things in life

As I've been told by my physio in the past, radiologists are paid to report on every little thing they see on the images, it's their job to do so, err on the side of caution

I've had a 1.5cm scarred over defect in my left knee, right on the weight bearing surface. Happened 7 years ago (along with a meniscus tear and a bone bruise covering a large part of the lateral condyle. yes, I needed surgery for the meniscus, I'm not able to run or kneel comfortably on it, but I've probably cycled 10000 miles, held down a full time job, been on numerous holidays since etc.

I've done now something to the knee again, after a twist but I don't think this is the cause

[tensters]

Thanks Vickster!
 
I'm definitely not considering surgery, it just seems to be the big treatment and concerned me a little. Wasn't sure what to make of all of that.

Reading the MRI some more, it also mentions no distinct fracture line - i assume referring to the lesion, and I guess that is good.

Yeah it does sound tiny.

[tensters]

So that twist is still bothering your knee? Did you see doctor?

[vickster]

Victoria

Don't dwell on it, just finish recovering and move forwards

I see my specialist next Saturday. GP thinks maybe collateral ligaments, physio suspects meniscus, I'll see what he reckons

[tensters]

Sorry! - I originally wrote Vickster but then rewrote the sentence and it somehow became Victor.

Good luck with the specialist!

[vickster]

Thanks. My insurer has also authorised an MRI so will see if the surgeon thinks it's necessary. The last one was 3 years ago I think