Comments on: Grading of Chondromalacia Patellae http://www.dxal.net/grading-of-chondromalacia-patellae/ Health, Finance, Science and Technology! Thu, 05 Jan 2012 22:50:15 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Grade 2 Chondromalacia http://www.dxal.net/grading-of-chondromalacia-patellae/comment-page-1/#comment-21933 Grade 2 Chondromalacia Mon, 16 May 2011 06:08:17 +0000 http://www.dxal.net/?p=440#comment-21933 I can tell what I've learned from my 1 year odyseey and 3 surgeries. I tore my ACL and posterior horn Sept. of last year. With a very difficult and painful recovery, at Christmas I called my OS and said I could no longer handle the pain. Even though he really felt it was due to scar tissue, he did an MRI. The MRI and subsequent surgery showed a large tear. My recovery from the second surgery continued to be difficult and painful. Finally 8 months after my first surgery, and 5 months after my second surgery I was back in the OS's office complaining of continued pain. Since I had no swelling, the diagnosis was bone on bone and a meniscal transplant was mentioned and a 2 -3 month wait and see decision was made. I also went to my GP who is team physician for a large college athletic program, and he looked at my knee, said no swelling, nothing to be done for right now - agreed with OS and wait and see. I would surely get better. Five weeks passed, and the anxiety and pain was too much. I needed information. I was referred to another OS who does mensical transplants. This experienced and well respected surgeon looked at my knee and said no swellilng, little meniscus left, and meniscal transplant ordered. At my appointment last week for my 1 week follow up for a meniscal transplant, I was told that what was left of my meniscus was shredded, rolled up in a ball, flipped over, and wedged in my joint. I don't think anyone anticipated that my meniscus had been destroyed to the point that it was. What I have learned from experience is you have to follow what your gut is telling you. None of my doctors, 3 to be exact and all qualified and doing their best to take care of me, did not expect the degree of damage. Repeatedly I have fallen outside of the expected showing of symptoms, and the normal recovery period. My last conservation with my old OS said "you have to tell me". I did not realize until that time how much the doctors where depending on what I said and what I needed. I think we all wish and hope that medicine is an absolute science, but it is an art. An art that is based on communication between doctor and patient. If you really think something is wrong, stick by your guns, and keep complaining until someone takes you seriously and does a through investigation of your pain. I can tell what I’ve learned from my 1 year odyseey and 3 surgeries. I tore my ACL and posterior horn Sept. of last year. With a very difficult and painful recovery, at Christmas I called my OS and said I could no longer handle the pain. Even though he really felt it was due to scar tissue, he did an MRI. The MRI and subsequent surgery showed a large tear. My recovery from the second surgery continued to be difficult and painful. Finally 8 months after my first surgery, and 5 months after my second surgery I was back in the OS’s office complaining of continued pain. Since I had no swelling, the diagnosis was bone on bone and a meniscal transplant was mentioned and a 2 -3 month wait and see decision was made. I also went to my GP who is team physician for a large college athletic program, and he looked at my knee, said no swelling, nothing to be done for right now – agreed with OS and wait and see. I would surely get better. Five weeks passed, and the anxiety and pain was too much. I needed information. I was referred to another OS who does mensical transplants. This experienced and well respected surgeon looked at my knee and said no swellilng, little meniscus left, and meniscal transplant ordered. At my appointment last week for my 1 week follow up for a meniscal transplant, I was told that what was left of my meniscus was shredded, rolled up in a ball, flipped over, and wedged in my joint. I don’t think anyone anticipated that my meniscus had been destroyed to the point that it was.

What I have learned from experience is you have to follow what your gut is telling you. None of my doctors, 3 to be exact and all qualified and doing their best to take care of me, did not expect the degree of damage. Repeatedly I have fallen outside of the expected showing of symptoms, and the normal recovery period. My last conservation with my old OS said “you have to tell me”. I did not realize until that time how much the doctors where depending on what I said and what I needed. I think we all wish and hope that medicine is an absolute science, but it is an art. An art that is based on communication between doctor and patient.
If you really think something is wrong, stick by your guns, and keep complaining until someone takes you seriously and does a through investigation of your pain.

]]> By: admin http://www.dxal.net/grading-of-chondromalacia-patellae/comment-page-1/#comment-21724 admin Fri, 08 Apr 2011 11:39:12 +0000 http://www.dxal.net/?p=440#comment-21724 Chondromalacia patellae was graded surgically by using the classi- fication presented by Shahnaree. Both traumatic and nontraumatic types of chondromalacia patellae were considered. In this classification, grade1 chondromalacia patellae due to trauma was reported to be manifested by softening, whereas that due tonontraumatic causes shows fibrillation. Grade 2 chondromalacia patellae was said to result from separation of the superficial layer of the articular cartilage from the deeper layer, resulting in a bulge or blister lesion. Vertical fibers become unmaskeddunng this process, and fissures maybe formed. Grade 3 chondromalacia patellae represents ulceration and fragmen- tationoflarger areas of cartilage. Fragments of cartilage may project into the joint space. Grade 4 chondromalacia patellae is diagnosed when large craters of exposed bone with underlying bony changes such as eburnation orosteophyte formation are present. Chondromalacia patellae was graded surgically by using the classi- fication presented by Shahnaree. Both traumatic and nontraumatic types of chondromalacia patellae were considered. In this classification, grade1 chondromalacia patellae due to trauma was reported to be manifested by softening, whereas that due tonontraumatic causes shows fibrillation. Grade 2 chondromalacia patellae was said to result from separation of the superficial layer of the articular cartilage from the deeper layer, resulting in a bulge or blister lesion. Vertical fibers become unmaskeddunng this process, and fissures maybe formed. Grade 3 chondromalacia patellae represents ulceration and fragmen- tationoflarger areas of cartilage. Fragments of cartilage may project into the joint space. Grade 4 chondromalacia patellae is diagnosed when large craters of exposed bone with underlying bony changes such as eburnation orosteophyte formation are present.

]]> By: admin http://www.dxal.net/grading-of-chondromalacia-patellae/comment-page-1/#comment-10542 admin Wed, 09 Jun 2010 01:09:57 +0000 http://www.dxal.net/?p=440#comment-10542 How do you prevent Chondromalacia Patellae? Short-arc extensions are done sitting up or lying down. Use a rolled-up towel to support your thigh while you keep your leg and foot in the air for 5 seconds. Lower your foot as you bend your knee slowly. Repeat 10 times for each leg, twice a day. Straight-leg raises are done lying down. Lift your whole lower limb at the hip with the knee extended, and keep it up in the air for 5 seconds. Then lower slowly. Repeat 10 times for each leg, twice a day. Quadriceps isometric exercises are done sitting up, with your legs extended in front of you. Tighten your quadriceps muscles by pushing the knees down onto the floor. Hold for 5 seconds. Repeat 10 times each leg, twice a day. Stationary bicycling on low tension setting improves your exercise tolerance without stressing your knee. Adjust your seat high enough so that your leg is straight on the down stroke. Start with 15 minutes a day and work up to 30 minutes a day. How do you prevent Chondromalacia Patellae?

Short-arc extensions are done sitting up or lying down. Use a rolled-up towel to support your thigh while you keep your leg and foot in the air for 5 seconds. Lower your foot as you bend your knee slowly. Repeat 10 times for each leg, twice a day.

Straight-leg raises are done lying down. Lift your whole lower limb at the hip with the knee extended, and keep it up in the air for 5 seconds. Then lower slowly. Repeat 10 times for each leg, twice a day.

Quadriceps isometric exercises are done sitting up, with your legs extended in front of you. Tighten your quadriceps muscles by pushing the knees down onto the floor. Hold for 5 seconds. Repeat 10 times each leg, twice a day.

Stationary bicycling on low tension setting improves your exercise tolerance without stressing your knee. Adjust your seat high enough so that your leg is straight on the down stroke. Start with 15 minutes a day and work up to 30 minutes a day.

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