Question: my brother had a grade 2 chondromalacia patella, i want to know what it means?!
Answer: Chondromalacia roughly translates to diseased cartilage. There are 4 grades of chondromalacia (grade 1, grade2, grade3 and grade4) that refer to the severity of the findings. Grade 1 is the least severe; Grade IV is the most severe. Grade IV chondromalacia refers to cartilage that is cracked/fissured to the extent the the bone directly underneath the cartilage (subchondral bone) is exposed.
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Topic: Grade 2 Chondromalacia.
Hi. This is my first post but I have had problems for 3 years and had arthroscopy on the R knee in may 2006 – did a medial synovectomy and shaved a 10x6mm patch of grade 2 chondro on med aspect of patella- the rest of the patella is grade 1.
I originally developed problems 3 yrs ago with heavy uphill cycling of an over loaded bike and had to stop after 3 days- since then I had a year of being painfree after excellent help with bike fit alignment by Dr Pruitt at Boulder, Colorado. However my problem returned after a year-hence the surgery.
I very slowly improved but after 3 months still could not step down stairs without pain behind the patella. This has not worsened but in the past 3 wks I have developed restpain (theatre sign) in BOTH knees. This gets very bad at the end of the day. I am using ice and having physio, taking glucosamine (for what its worth) and ibuprofen. I have tried steroid inj and my OS now suggests Sinvisc.
My question is:
Has anyone had similar chondro that has improved or am I doomed to be in pain and being inactive for the rest of my life ?
I have spoken to 4 OS who all seem to be positive but the whole issue still seems a bit vague and I am still in loads of pain especially after sitting or even climbing one flight of stairs.
Any opinions would be appreciated.
I’m not sure what to tell you, except to ask if they know what has caused your chondro?Chondromalacia really just means a thinning of the cartilage, but is not really a diagnosis in itself because it does not get to the bottom of the problem. What is causing the thinning? Is it just “wear and tear” from age, was it caused by an injury, maltracking? I think you have a better chance of reducing your pain if you know what is really causing it, and can be treated for the underlying reason.
I’m not sure what to say, but 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.
Good luck and let me know what happens.
Symptoms:
A grating or grinding sensation when the knee is extended
Knee pain in the front of the knee that worsens after sitting for a long period of time
Knee pain that worsens with using stairs or getting out of a chair
Knee tenderness
What is mild grade 2 patellar chondromalacia and adjacent inflamation Hoffa’s fat centrally. Moderate sized joint effusion and small Bakers cyst. Mild reactive chondromalacia of the weightbearing surface medial femoral condyle. Slight edema deep to the ilial tibial band suggest a mild friction syndrome.
Hi!
This type of anterior knee syndrome required MRI for Diagnosis. second cool pack and physiotherapy help a lot. You can do ilitibil band/iliopsoas, Harmstring and quadriceps exerrcise. you will imrove a lot.
pl do it
What are the long term effects of this disease. If you do the exercises is it supposed to stop any further degradation? If I keep my muscles strong will that prevent the kneecap from leading to grade III and IV?
I posted a comment asking about grade 2, which was removed without being answered. My question was is progression to grade iii and iv inevitable even with muscle exercises? A woman i spoke to who has the same problem said yes. I am assuming b.c my comment was removed the first time the answer may be yes.
My MRI in Oct2010 showed grade 2 patellar chondromalacia and inflamation Hoffa’s fat pad. I had been for physio for 6 months+ to strengthen quads but now find that I experience pain continuously with even the usual activities. In the past, when my problem manifested, I used to run ~80km per week. Needless to say, I cant do that anymore (driving me mental) but am concerned that activities like pushing a trolley, walking, climbing a few stairs, even sitting etc. is taxing on my knee and very painful.
Can anyone advice on what has worked for them? Any help will be most appreciated.
Kind regards
Dhaya