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Author Topic: normal cartilage and osteophyes???  (Read 104 times)

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Offline robertb

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normal cartilage and osteophyes???
« on: November 17, 2020, 05:42:05 PM »
Hello everyone!

I had a quick question about a recent knee issue I have been having.  Short history, I had an ACL reconstruction back in 1996 that I recovered from completely.  Had a lateral release done in 2003 (didn't need and I try not to dwell on it) and then a 3rd surgery shortly after to clean up some massive scar tissue I had developed from the lateral release.  Since 2003, my knee has been fairly good until recently.  The lateral release did weaken it considerably, but I didn't have any issues until about a year ago.

About a year ago I tweaked it while my knee was planted in deep flexion stepping down from a large step and started having some pain/catching with certain movements on the lateral side.  I didn't go get it checked out at first and then Covid hit so everything was closed for awhile keeping me from seeing the specialist.  So finally a couple months ago I get in to see the specialist about my knee, which hadn't really gotten much better up to this point.  We get an MRI done which brings me to my question.  My issues are on the lateral side, and the MRI didn't show anything torn (which was surprising).  What's puzzling though is this interpretation by the radiologist:

Lateral Compartment:
Lateral Meniscus: Normal
Lateral Collateral Ligament: The proximal thickening compatible with prior sprain.
Lateral Femoral Condyle Cartilage: Normal.  Osteophytosis
Lateral Tibial Plateau Cartilage: Normal.

The bolded above to me is confusing.  How can I have normal cartilage on the lateral side AND osteophytosis?  I am under the impression that osteophyes are in essence bone spurs that are caused by bone on bone contact.  My cartilage is normal however showing no wear and tear, so I shouldn't be having any bone issues.  This diagnosis seems contradictory to me.  Can anyone shed some light on this?  I know this is probably a question for my doctor, but I just recently obtained a copy of the MRI report and I won't be seeing the doctor for some time.  Thank you for reading!

Offline vickster

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Re: normal cartilage and osteophyes???
« Reply #1 on: November 17, 2020, 07:54:30 PM »
Fibrocartilage covering arthritic cartilage defects (that’s the case in my knee)? Not necessarily distinguishable from ‘normal’ cartilage cover on MRI.
My MRI reports are quite different to the actual state of my cartilage observed in arthroscopy. Grade 4 defects in all compartments filled with fibro vs ‘mild thinning’ in MRI report
« Last Edit: November 17, 2020, 07:57:59 PM by Vickster »
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 robertb

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Re: normal cartilage and osteophyes???
« Reply #2 on: November 17, 2020, 10:16:08 PM »
Fibrocartilage covering arthritic cartilage defects (that’s the case in my knee)? Not necessarily distinguishable from ‘normal’ cartilage cover on MRI.
My MRI reports are quite different to the actual state of my cartilage observed in arthroscopy. Grade 4 defects in all compartments filled with fibro vs ‘mild thinning’ in MRI report
I appreciate the reply.  I am learning more and more that MRIs don’t seem to be all that great in diagnosing knee issues.  My X-rays showed normal joint spaces so that coupled with normal cartilage indication on the mri I was hoping I didn’t have arthritis in the knee yet, at least nothing major.

I am doing PT right now which has been helping a little bit as my leg has gotten pretty weak in the past year, but my specialist is wanting to go in and do exploratory surgery if I’m not satisfied with PT results.