The Dr who ordered the MRI couldn't explain the results to you?

He isn't a knee specialist so all he said was there is cartilage pieces floating around in your knee and some damage but didn't know what procedure the surgeon could do to help/fix it.

Sorry to hear. Knee injuries are a bummer. I busted up my knee skiing a couple of winters ago and ended up with similar cartilage defects as well as a defect on the back of the knee cap. At this stage, my guess is the answer to your question about prognosis is "it depends" when my ortho did my surgery to clean out my knee he found that the defects had spontaneously started to fill in with fibrocartilage (not near as good as the original parts, but better than nothing) he also found that the defects were in more of a non weight bearing region than the MRI seemed to indicate so he gave me the green light to return to swim/bike/run. It's been 2 years and so far the knee has been good but I do feel like it's a bit of a ticking time bomb now and that I may need further intervention/a new knee one of these days. Feel free to PM with any specific questions.

Also, there are a few ortho docs on here who might be able to provide more insight.

Thanks for your reply! It's nice to know there is hope!!

Just curious *when* you experience the locking?

I've had a couple knee surgeries - both ACL - on my left knee. There was a point in time after the first one where I had a similar issue. It was always related to running, though. It helped a lot to get on the bike trainer for 15 minutes or so and just spin before doing any running.

After my 2nd surgery, they cleaned up more of that and it hasn't been a problem. But I'd definitely suggest talking to a surgeon who focuses on sports injuries and see what he/she thinks. They may want to schedule an arthroscopic procedure so they can get a better look than the MRI - and possibly do the repair at the same time.

edit: btw my first ACL repair was at age 19 and I'm 44 now. Still running. Hang in there - they are really good at this stuff nowadays.

Locking happens super randomly, usually when I'm standing or walking. I haven't ran a step since January because of the injury, I do find that biking on the trainer makes it feel much better. Thank you! Good to know you are still running 25 years later, I'm hopeful now :D

Hey - I am not an MD but I had exact diagnosis you had (osteochondral defect on the lateral femoral condyle) but they did not mention "subchondral sclerosis." What happened with me is a few weeks after a marathon I was doing a short tempo run felt great but later that day the knee started to swell up, but no other pain, which ultimately led to MRI and diagnosis. It was explained to me that I probably had a congenital bone weakness that eventually gave way due to too much running - basically like a cavity in your bone. What they did was first go in arthroscopically to remove the debris and check out the lesion. Then I was put on a donor register and about 6 months later I had an allograft where they basically stick a donor bone/cartilage plug into the hole in my femur. Image search for "femoral osteochondral allograft" and you can see the basic idea.

From what I learned, the first preferred treatment (mostly I think due to cost) is microfracture which is quick and dirty but has a bit of a dubious history in terms of long term prospects. Then there is experimental stem cell options but pretty untested and generally not covered by insurance. My lesion (I dont recall exact size) was too big for microfracture so I qualified for the allograft which I think, all things considered, was the best option because I get brand new cartilage. Recovery was a bitch, 8 weeks non-weight bearing, tons of rehab. But I am old (45). Maybe I could run again in moderation not ultras like I used to do but that is basically a personal decision - I didnt want to risk not being able to hike with my yet-to-be born grandkids so I retired from running now I just swim and mow the lawn, getting back into biking. Knee swells when it is going to rain but other than that pretty darn good. Anyways that was just my deal, wanted to share but you may be in completely different boat - just do your research, find experts you trust, and don't rush the recovery!

Hey! Thanks for sharing your story, I appreciate it! I'm in Canada so I don't know how the whole process will work out but I will definitely look into what the options are to be ready to meet the OS, I met one doctor who didn't want to do anything but cortisone so I'm waiting for a second opinion.

There's a huge amount of "it depends" here and an ortho would certainly know better in terms of the location of your defect, but just to give you a bit more hope (there were pretty much no success stories on the 'net when I went through this and I would have loved to have a little reason for optimism at the time)...

I had a fairly large osteochondral defect in 2010. Had the microfracture surgery- I was almost to the point where the defect was too large and would have required a graft. Recovery sucked- several weeks completely non-weight bearing and then many months of PT- but I was very patient with it and didn't try to push anything. I was 30 at the time.

Long story short, my doc said running might not be in my best interest and I basically ignored that as it was not an outcome I was willing to accept. Have since done 8 Ironmans and something like 25 x 70.3s, run faster now than I did pre-surgery, and race at the pro level. Knock on wood, that knee really hasn't caused me issue, although it's always in the back of my mind that the microfracture could still fail on me. That was and is a risk I am willing to accept. Everyone's values are different, though.

So, keep hope alive! Good luck!!

Ahhh thanks for sharing this :) It seems that microfracture has a big chance of failure but it's great to hear success stories lile yours!