Knee Cartilage worn out - dr recommends synthetic - any experience?

take care of yourself wrote:

Make sure your legs are balanced, your activities are balanced, and that your shoes are balanced, not tipped way in the air from the heels that would put stress on your metatarsals, shins and knees.

Hear, hear! And:

Although I think orthotic devices were much over-prescribed ~30 years ago, they unquestionably have helped a lot of people--in particular, they have helped *some* people's chondromalacia.

If you have a leg-length imbalance, or a footplant that "tracks" through your kneecap improperly, orthoses might be very helpful. I believe that they gave Dave Merrick (great Penn runner of the 1970s) some relief, when multiple knee operations did not.

ScrapIron Steve wrote:

So do you have a replaced joint and are you speaking from experience? And what basis do you have for your view on Synvisc (or any other fluid repl for that matter)?

Not really worried about infection as the radiologist is good about that, I have had a couple cortisone injections, and they seem to work well but I don't want to compromise the femoral head with repeated treatments.

Thanks again!

Scrapiron you might be interested in this about a fellow triathlete:

resurfacing as opposed to THR

That sounds extremely painful.

The microfracture surgery recovery wasn't pleasant, and for much of it my only desire was to be able to walk again. But it ended up working great. It's been 3 years since my surgery, and this morning I ran 18 miles. I'm planning to do the Baltimore Marathon in October and race about twice a month.

I'll share my story . . .

Went in for plica removal and ended up with a microfracture. Well, the microfracture didn’t work. I sill had a defective spot about the size of a half dollar coin under my knee cap, were there is no cartilage.

Then in my second surgery they tried an Osteochondral Autograft. This technique is like a hair-plug transfer. They remove a small section of cartilage and then move it to the defective spot. However, once they got in there, they realized the spot was to large to fill. The size of the defect treatable with this method is usually between one and two square centimeters, or slightly larger than a thumbnail.

They ended up doing an “Autologous Cartilage Cell Implantation”. ACI is a two stage process. They took out a small amount of my cartilage. Through cell growth and culturing techniques, the cell number is increased from a few hundred thousand to over 10 million cells. In the second stage, the cells were implanted in my knee in a second surgical procedure, under a patch which is sewn to the neighboring cartilage.

I had this done about four years ago. I can run, but not like I’d like too. My knee feels okay, if I don't do too much. My quad is still week and I just can't get them balanced.

An ACI might be an option; I just hope you recover better than I did. The recovery is very long. Just another idea.

bionic 2008 wrote:

On a side note, the therapists told me that because I had been a runner, the muscles surrounding the knee were in great shape and very tight, which resulted in a lot of pain as I worked thru the therapy. The people who aren't in good shape have looser muscles and it's easier(less painful) for them to start flexing the knee joint.

Ok this brings up an interesting point. I'd like to get a poll going along with all of the middle aged runners here experiencing cartilage loss.

Were you an avid stretcher before or after your surgeries?

Did you take any sort of known joint fluid supplements such as glucosamine chondroitin before or after your surgeries?

I like taking at least one day a week off and taking two to three weeks off after the competitive season or a significant effort.

I wouldn't be able to run hundreds of days in a row. And to do that (or a marathon) after you fix your screwed up knees seems crazy. If it were me coming back from screwed up knees, I would just train for the 800m for fun and keep the mileage at 30 mpw.

I stretch about the same amount now as before surgery. I do take Glucosamine now, but didn't before. Early onset arthritis runs in my family, so that had a lot to do with my knee.

I just had my knee scoped for the second time in 8 months. Torn meniscus both times even though I barely got back to 2-3 miles of running on soft surfaces. I don't think he got everything the first time. He said there was fraying on the original site as well as a flap tear and he saw some arthritis so he smoothed out behind the kneecap. I don't think I'm bone to bone but my surgeon did tell me wife that I'd have to vary my fitness routine-which is interesting given that all I've done the 3 months prior to surgery was bike!!

I take glucosamine chondriotin and will do all the strength and stretching items that the PT gives me to do religiously (I'm a PE teacher and a track coach).

My thought is this. How many have switched from just running to triathlons successfully?

Have you looked into ACI or MACI?

Wanted to bring this thread back up to hear any new stories or updates.

I've had recent pain around my knee (more on the outside, and in the back, not in or behind the kneecap. It is real stiff getting out of bed, and those first few steps after sitting for a while) and the 'good news' is the MRI does not show anything torn, so no arthro is necessary.

However, the dr. did say it is pre-arthritic. He suggests starting with PT, and if that doesn't work move on to cortisone and then the synthetic stuff.

Anyone else experience this condition? What worked best for you?

Thanks.

bumping this thread because I am in the same boat