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Author Topic: chondral fissue lateral/medial trochlea & fissure in lateral/medial retropatella  (Read 250 times)

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Offline cooperd70

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48 year old male.  Recently had MRI on left knee.  Pain started in mid Dec last year when climbing stairs, got worse over a period of two weeks to the point where I stopped cycling as I was unable to get out of the saddle and 'mash' the pedals.
MRI confirms full-thickness chrondral fissure in the lateral trochlea, tiny full-thickness chrondral fissue in the floor of the medial trochlea.   Full-thickness fissure in medial retropatellar cartilage and partial-thickness lateral retropatellar chondral fissure. Early chondropathy in posterior aspect of the weight bearing medial femoral condyle, but no definite full-thickness loss.  Tiny full-thickness defect seen in the posterior aspect of the lateral plateau.  No meniscal tear. Cruciates, collaterals and extensor mechanism are intact.  Mild insertional quadriceps tendinopathy .  Small joint effusion, small ganglion seen at distal adductor magnus insertion.
Took time off of my bike (nearly three months) and took it easy on the knee (not climbing stairs if I didn't need to).  Just after MRI, but awaiting to see someone here in the UK (NHS) I decided to start to cycle daily again,  but to spin in lower gears which has worked well for me, albeit awkward when pushing off from traffic lights here in the city.  Still pain climbing stairs/walking down slopes/hills (walking up slopes/hills or on the flat = no pain at all).
It seems that the possible culprit to the fissures may have been a cycle accident approx two years ago.  Left knee was whacked and became swollen and bruised.  Nothing was done (medically) at the time...three weeks in and the brusing/swelling was on its way down and had no issues/pain afterward, right up until Dec just gone.
Does anyone have any experience of these cartilage issues?  Pain is not every step climbed, one step no pain, but can get pain on next step.  Sometimes knee feels like its just going to give way.  Location of pain can be hard to describe, sometime in the knee, sometimes it feels at the top over the lower leg below the knee, and feels not too unlike the same pain you get from shin splints.
Just (like everyone on here I suspect) want to get back to my normal routine and to be able to get out of the saddle on my bike, rather than feeling like an old man when I'm just 48.
Any advise greatly appreciated.

Offline RGB

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Hi there. You'll find a lot of threads referring to various treatments for your condition. In my view, the best summary was given by Dave33 recently. See his post on April 7 here . It's not clear to me how much damage you have but I'd counsel against doing anything that makes it worse - if the lesions get large, you're going to regret it. Find a physical outlet that does not make your knee worse and learn to love it. If it's cycling without getting out of your seat then you're a lucky man. I developed similar problems to you at about the same age but the damage got pretty bad before I knew what it was. Once I did, I tried lots of different things - microfracture, chondroplasty, PRP and stem cell injections and finally Dr Saw's microfracture/stem cell treatment in Malaysia. This all took 7-8 years, during which climbing more than one flight of stairs a day led to pain and swelling, my formerly active life was severely curtailed and I couldn't do much of anything with my young children. Nothing worked and I finally had a PFJR just over a year ago (aged 55) and it's great. You'll find a couple of posts by me on my post-op activity levels. However, that's a drastic option and you want to try very hard to avoid damage severe enough to justify it. There's a lot that can go wrong and it may not be open to you anyway if you have tibiofemoral damage. Hope this helps.