Articular cartilage tear

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Articular cartilage tear

Postby Bentnose » Wed Jul 24, 2013 4:55 pm

I've just received the MRI results back after injuring my knee at work. The report mentions extensive tearing of the articular cartilage at the apex and lateral facet of the patella with prominent articular cartilage flaps seen. No tendon damage occurred and the cartilage in the trochlear groove is normal.

Does anyone have any first hand experience with this type of injury? Its another 14 days till I can get in to see the Orthopedic Surgeon, even though my case has been classed as urgent.
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by BNA » Wed Jul 24, 2013 5:16 pm

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Re: Articular cartilage tear

Postby elantra » Wed Jul 24, 2013 5:16 pm

Really to answer your question one would need a lot more information, like what happened, is it still swollen, does it hurt to walk up stairs etc. etc. etc.

Obviously no-one wants their life's activities to be left in limbo awaiting an appointment that is 2 weeks away.

Did you see a GP after the accident ?

If so, the GP could perhaps interpret the MRI / clinical situation, or alternatively could refer you to a physio who is experienced in knee injuries.
"Technology gives us much more information but Education is never be able to give us the skill to evaluate it"
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Re: Articular cartilage tear

Postby Bentnose » Wed Jul 24, 2013 5:32 pm

Its not swollen, the biggest issue is fully straightening it is uncomfortable and if I walk (limp) a little too fast it becomes painful around the area of the tear, below the patella about centre. Stairs are dificult and have to be taken slowly generally favouring my left leg. When I did it all I was doing was stepping up onto something, felt a pop and quite a bit of pain and had the knee collapse under me. It has been a little better every day, though it probably won't get too much better than it currently is. Its all covered by Workcover, luckily and I'm on modified duties at work. The GP says I need to see the Surgeon before any Physio treatment can be done.

Just hoping for someone who has seen similar injuries to get an idea of what I'm up against
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Re: Articular cartilage tear

Postby moosterbounce » Wed Jul 24, 2013 11:03 pm

Sounds nasty. Some wiki reading was enlightening and you have my sympathies on the wait time - I've got 2 weeks to wait to see my knee man and am mostly on crutches ATM and have been for 4 weeks. Looks like most people here have had meniscal tears of various forms.

Seems like surgery may be the only option due to no blood flow to the area etc, and regeneration isn't happening though there have been heaps of advances with stem cell therapy (they harvest from your belly fat or similar).

I'd suggest if the doc recommended keeping off it, then grab some crutches.

Keep us posted as to your prognosis and recovery. Good luck :)
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Re: Articular cartilage tear

Postby elantra » Thu Jul 25, 2013 12:21 pm

Bentnose wrote:Its not swollen, the biggest issue is fully straightening it is uncomfortable and if I walk (limp) a little too fast it becomes painful around the area of the tear, below the patella about centre. Stairs are dificult and have to be taken slowly generally favouring my left leg. When I did it all I was doing was stepping up onto something, felt a pop and quite a bit of pain and had the knee collapse under me. It has been a little better every day, though it probably won't get too much better than it currently is. Its all covered by Workcover, luckily and I'm on modified duties at work. The GP says I need to see the Surgeon before any Physio treatment can be done.

Just hoping for someone who has seen similar injuries to get an idea of what I'm up against

Sounds like a bit of an unusual type of knee injury.
Obviously i agree you need to discuss it with Orthopaedic knee specialist surgeon.
But in the interim there may be some advantage to you in seeing a physio, especially if you are on workcover. (workcover usually pays for this)
Even if the physio says something like "lets wait till we hear what the surgeon wants to do" - he will probably be able to give you a bit more insight into what the damage is, and will probably be able to give you some gentle leg exercises which will hopefully preserve your quadriceps muscle strength without aggravating the articular damage etc.

Personally i have had articular cartilage injury myself.
This was quite a nuisance for me many years ago.
"Resting the knee" is not the same as "not using your affected leg"
"Technology gives us much more information but Education is never be able to give us the skill to evaluate it"
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Re: Articular cartilage tear

Postby CXCommuter » Thu Jul 25, 2013 2:46 pm

I tore a sizeable chunk off of the medial aspect of my left patellar as a result of a full blown dislocation in the late 1990's (thumbnail sized). This was completely torn off and jammed in my knee joint, which was not a load of fun. Recovery after surgery was f______g painful but over time has settled with permanent crepitus. This limited my options to stop the recurrent dislocations until patello-femoral reconstructions where introduced in the early 2000's (I was one of the first in the country). The only issue I would say is to work bloody hard at regaining quad strength (particularly VMO) even if it hurts at the start. BTW my left leg is favoured on the bike by about 10% as a result of not being able to put full power down but hasn't massively limited me

Oh also boron, fish oil and glucosamine should become your lifelong intimate friends
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Re: Articular cartilage tear

Postby Bentnose » Thu Jul 25, 2013 9:13 pm

That sounds nasty CXCommuter. I think I've had crepitus for years, just didn't know what it was called, didn't cause any discomfort, just my knee would crackle as I climbed stairs, had an MRI 8 years ago and was given the all clear. I've been on the fish oil for years as well, at least I've got that going for me, I am using the knee and almost walk normally, albeit slowly, any attempts to pick up the pace lead to a fair bit of discomfort. I did quite a bit of walking today, though needed some Voltarin at the end of the day. The GP treating me has specifically said no Physio till I see the surgeon, so I'll have to follow his advice, particularily because it is Workcover, if something went wrong I'd be in the poo. The GP did tell me to make sure I do use it, though not to strain it or overuse it.

And yeah Moosterbounce I am a little worried about the information I've read about the lack of regeneration of the articular cartilage. Looking at the MRI with my non existant medical knowledge the cartilage in question appears to have multiple tears, but it could be me just looking at it wrong. I am surprised by the lack of pain though it appears there is little in the way of nerves around the area.
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Re: Articular cartilage tear

Postby Bentnose » Thu Aug 08, 2013 8:30 pm

I've seen the surgeon, turns out I was looking at the wrong thing on the MRI. It appears that for some reason my patella shifted while I went to climb up a step and tore off some cartilage. She said its clear cut and it sounds like she wants to do it in the next few weeks; just have to hope Workcover don't stuff around too long approving it. I'll be off work for 6 weeks at least and will be able to do very little. Its a bit sad to think how thin my cartilage will be once it has the tears trimmed out of it. I'm told lots of walking, stairs, crouching and ladder climbing etc.. will probably lead to a sore knee in the future. Seems like cycling should be no real issue.

In the mean time I can ride my bike, I just need to listen to my body and back off if necessary. I rode on the indoor trainer last night for about 45 minutes; I could mantain my HR in the mid 130's but any harder caused knee discomfort, no real ill effects in the morning, knee was aching a bit but it has been doing that every morning for the last few days and I just wack a support on, which helps.
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Re: Articular cartilage tear

Postby NeillS » Fri Aug 09, 2013 9:47 pm

Sounds like you've had patellar mal-tracking for many years (old crepitus can be a sign) and the thing has managed to shift under heavy load which has caused the flaps/fissures. Pretty random turn of events considering you'd been essentially symptom-free for many years but this stuff is not as unusual as it should be - I see versions of it now and again. Do bucketloads of VMO strength work and get a talented physio to find out why you had patellar maltracking in the first place - prime candidates are heavily pronating feet, valgus-deviated knees, weak glutes etc etc etc. If you can fix the reason for the maltracking in the first place, the remaining cartilage will last a lot longer!
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Re: Articular cartilage tear

Postby foo on patrol » Sat Aug 10, 2013 9:22 am

Just make sure you don't over load it and do the exercise within the limits. Get things nicely fixed up and healed and Bobs your uncle, hopefully :)


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Re: Articular cartilage tear

Postby Bentnose » Sat Aug 10, 2013 2:03 pm

I have a cycling specific Physio I have used in the past and he is very good. I'm sure after the operation I'll be needing physio, I'll get him to look into trying to find the source of the issue, I definately wouldn't want it to happen again!
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