Anybody have any experience with this type of injury. I’ve been dealing with it for about 6 months now and I’ve had no luck with it healing. Its brought on by running. The pain is small and really doesn’t hurt at all when running, but the knee has a dull pain in it most of the time.
How was the diagnosis made?
If this truly is the cause of your symptoms, it doesn’t really ever “heal” in the sense of being repaired whith cartilage, though it can become less symptomatic with time.
Deke
I posted a message on Gordo’s forum about this. The summary of the MRI is in that thread:
http://www.coachgordo.com/forum2/upload/index.php?showtopic=2094
If you still have a muscle imbalance, you might try rest and PT, then have someone look at your gait. Persistent unilateral weakness can lead to all kinds of problems, include a bad gait. A repeat MRI might be necessary.
I think that your thoughts after reviewing your ACL video are correct - people who have ACL tears have an increased risk of osteoarthritis, thought to be from chondral injuries at the time of the initial tear. Pretty hard to say this without seeing the MRI or your knee, but by that MRI description, this doesn’t sound like overuse or alignment issues - they don’t tend to give you a localised area of damage.
You might want to ask your docs about osteochondral autografting, also called OATS or mosaicplasty. If, and there is a big if, your symptoms come from the chondral damage, it could help. Personally, I would also try glucosamine supplements. There is no evidence that Hyaluran or other viscosupplementation injections provide more than short term relief, and they do not, as suggested on the other forum, act as a super glue. Finally, it might be that running is not good for a damaged knee like yours, but there may be other things to try before you decide this.
Good luck,
Deke
"Articular cartilage defect on medial femoral chondral " - This was my diagnosis in April of 2003.
A little background - I had started running again in July 2002 after losing (at that point) over 60 pounds. By March 2003, I was down another 60 pounds. I did a 8K race then went out for a bike ride in the afternoon (one of those rare 60+ beautiful March days in Chicago). I noticed that my knee didn’t feel right the next day - kept feeling like it wanted to “pop” but wouldn’t. I ignored it and continued with my workouts. By the following week, I was experiencing some stiffness in the joint but continued to ignore it. When I couldn’t get out of a chair the following Saturday without an excruitiating pain when I would straighten the joint, I realized I had to do something. I saw an orthopedic doctor the next Tuesday. The initial diagnois was a tear of the meniscus, but he sent me for an MRI to confirm. The MRI showed that the meniscus was fine, but that there was a defect in the cartlilage. I refused the cortisone shot since I didn’t feel like that was treating the problem, just the symptoms. The pain had subsided a lot at this point, but the knee would still “catch” when I would straighten it unless I was very, very careful getting up out of chairs, out of my car, etc.
I decided to have arthroscopic surgery on the knee at the end of April. The doctor cleaned out the loose bits of cartilage that were floating around in the joint. He also did a procedure where he scraped the bone where it was bare (my defect is about 3cm x 1.5 cm) to stimulate the bone to bleed and produce a scar cartilage. He said if this procedure didn’t work, the next step is to go to consider either Osteochondral autograft (plugs of bone/cartilage) or Autologous cartilage cell implantation (Carticel). He also suggested that taking glucosamine might help my situation.
I wasn’t able to run or do any fitness walking for 6 weeks after the surgery. He did encourage me to swim and bike as much as I wanted. I had my first triathlon schedule for the end of June and was really upset that I might not be able to do it. I got a few short runs in before the triathlon and successfully completed it although I did feel some discomfort in the knee.
In July, I had more problems with pain in the knee and had to lay off running for another month. I finally stopped having discomfort with day to day activities about mid-August. I resumed running on a regular basis in September 2003. But from time to time I would still have problems with the knee.
Fast forward to December 2004. I just did a 15.2 mile run yesterday and the knee felt fine the entire time. I did my first half-marathon on Labor Day without problems. I am running 30-40 miles a week (spread out over 5-6 days).
I feel the big turning point with my knee came this past June when I finally realized that since I overpronate that I probably should be using arch supports in my cycling shoes in addition to my running shoes. I was experiencing pain in the knee when I would get off the bike after long rides. Once I put the arch supports in (Dr. Scholl’s) my cycling shoes, the knee pain while cycling vanished and that translated to reduced discomfort when running. I also found that doing progressively longer, slower runs (10+ miles) seemed to have a positive effect on the knee versus short, hard efforts. And I take glucosamine on a daily basis.
If you have any other questions, please feel free to email me directly.
Good Luck!