Patella Cartilage damage - what is next? (MRI Pictures - page 2)

[Brandon123]

Thanks RGB, for sharing your experiences. Unfortunately, I've reached similar conclusions based on my own research and discussions with other PFJ-sufferers. You said you had a central cartilage defect? Was it just the patella or also trochlea? Full-thickness? Isolated defect of arthritis type wear and tear?

Regarding the age, yes, 37 feels a bit too young for PFJR, even though some people nowadays get them in this age I guess. But if you were 57 when you got your PFJR I think you're probably in a quite good situation. Even if your PFJR would only last 10 years and you were forced to revise into a TKR, you would still be in the safe zone

[RGB]

Hi Brandon. In a hurry so will be brief. First defect was central trochlea full thickness. Likely consequence of an ACL reconstruction 20 years previous using the patellar tendon which slightly disturbed the alignment. After the first micro-fracture another full thickness lesion on the central patella developed. Regards.

[Brandon123]

Thanks for the info RGB, that's quite much damage! I understand if it was difficult to repair/fix.

[Dave33]

The 10 years of activity restriction was tough to endure and I never did learn to cope well with my restrictions - I was constantly railing against them and trying to improve, to the extent that I didn't give other areas of my life the focus they deserved. I feel like cartilage restoration technology is not yet sufficiently developed to be considered a reasonable alternative so in my opinion for my type of patello-femoral damage it's conservative (non-surgical) treatment or PFJR, with nothing useful in between. Sorry - a bit gloomy. Regards.

Same experience, same opinions.

One thing that isn't talked about enough is the psychological aspect of knee issues. You can find yourself in a mental hole that revolves around the obsession over getting better and constantly failing for years and years, at the same time getting unhealthier both physically and mentally. This can really change the person you are, and I wouldn't wish it on anyone.

Same caveat as RGB; I'm not a doctor, any my opinions are my own, but having had 8 operations on my pf joint, involving advanced cartilage regeneration attempts, I'm very, very skeptical of any biologic or realignment solutions for advanced central/medial PF damage, and I wish I hadn't done it. Not because it burned any bridges, but because the investment of time, pain, and hope each time was crushing when it didn't work.

Wishing you the best.

[reflex_nl]

Hi Dave33 and RGB,

Thanks for sharing your stories, indeed the whole psychological aspect is not enormous. It impacts so many aspects of your life. Surgery not always a solution and, they cannot pinpoint the root cause of the pain. Especially the PTFJ is most difficult to treat... I regret my choices for MCIC/advance MFX as well. Despite the good "stories" on websites / official medical journal articles, it made things worse.

@RGB, did you consider ACI for the patella? it seems the newer ACI generations have better results.

I'm 38 years old.... and have no clue what to do now, after 2.5 years in pain.

Reflex