Arthroscopy Patella Cartilage Debridement

[NorthumbriaKnee]

An update......Baby steps continue. Drove 7 hours each way through a snowstorm (6 feet in the mountains!!!!) to have the Steadman Clinic do an exploratory assessment of the knee as well as a debridement and PRP.

First of all the Steadman clinic is great. My surgeon is Dr. Vidal, can't recommend working with him/them highly enough.

What was found when he went inside were 2 lesions both on the trochlea. The larger one was ~14mm the smaller ~10mm. The MRI indicated another lesion on the patella but was not found visually. Otherwise the said the knee was in great shape. He did mention that the larger lesion had a blister or cyst (I was foggy talking to him post op, so may have the terminology wrong).

The plan is to wait 3 months for full recovery and then determine whether this did enough. He said due to the good condition of the knee and my desired activity level, if we did have to go forward it would be with OATS and TTO, not PKR.

That being said 2 weeks post op, so far so good. I really won't know whether this debridement did the trick until I am allowed to take the knee out for a run/climb/MTB/HIIT. All of that is off limits until 6-8 weeks post op

Hi there,

I am new here but I'm intrigued by ColoradoSnowman's story. 1 year ago I ruptured my right patella tendon. Fixed, all good. Took a long while to rehab though. I still haven't run because during rehab I injured my cartilage in my left kneecap. MRI showed small unstable flap on the medial facet. On the 5th of April I had arthroscopy with debridement of that flap and a fissure debrided below it in the trochlear groove. I am slowly recovery. Sharp debridement pains have subsided but I'm still getting intermittent dull ache. I am so limited in what I can do. Even a walk might bring on a dull ache etc. Coloradosnowman, please let me know how you get on as I think I have very similar pathology. The pain is just tiring. I'm 46, I like to swim but can see that either a patellofemoral replacement or a TKR is on the cards potentially for me.

 

[Jockette]

@NorthumbriaKnee Hi and Welcome!

I’ve moved your post to a recovery thread of your own so we can discuss your recovery and keep your history together. Colorado Snowman will see that you quoted his post and he’ll probably come here to this thread to reply.

1 year ago I ruptured my right patella tendon. Fixed, all good.

I’m glad that this healed well. If there was a surgical procedure, please give us the date and we’ll put it in a signature for you. This helps us to see your history.

On the 5th of April I had arthroscopy with debridement of that flap and a fissure debrided below it in the trochlear groove. I am slowly recovery.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

​

If you want to use something to help heal the incision, ​

BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

3. Do what you want to do BUT

​

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

​

​

4. PT or exercise can be useful BUT take note of these

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity Progression for TKRs​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[Jockette]

And if you’d like a new title for this thread just let us know what you want and we’ll change it for you.

 

[NorthumbriaKnee]

Thanks for this Jockette, very kind of you.

 

[lrj]

I'm 46, I like to swim but can see that either a patellofemoral replacement or a TKR is on the cards potentially for me.

I had arthroscopic debridement around the age of 33. I'm now 37 and have had patella femoral PKR in both knees. I know I'm ahead of the curve compared to most. At 8&5 months post op, I can do yard work and hike again. I could do so much last year. It wasn't just the pain, but I was experiencing weakness.
Because of my age, I struggled to find a doctor who would do the surgery. I had to travel 6 hours to get mine done, despite living near a large city. I had multiple surgeons tell me to wait till I'm 60, when I was 35 at the time. 25 years is too long to live like that.
I love my new knees! It's a rough experience, but I now have my life back!

 

[NorthumbriaKnee]

I'm 46, I like to swim but can see that either a patellofemoral replacement or a TKR is on the cards potentially for me.

I had arthroscopic debridement around the age of 33. I'm now 37 and have had patella femoral PKR in both knees. I know I'm ahead of the curve compared to most. At 8&5 months post op, I can do yard work and hike again. I could do so much last year. It wasn't just the pain, but I was experiencing weakness.
Because of my age, I struggled to find a doctor who would do the surgery. I had to travel 6 hours to get mine done, despite living near a large city. I had multiple surgeons tell me to wait till I'm 60, when I was 35 at the time. 25 years is too long to live like that.
I love my new knees! It's a rough experience, but I now have my life back!

Hi Irj,

Thanks for the insights. Very reassuring. Glad that your pkrs have worked for you. Did they originally debride flaps under the patella at age 33? Did that help at all? If so, for how long? Really struggling to find people who have undergone patella cartilage debridement. Lots of meniscus tears, but not many for patella cartilage.

 

[lrj]

Mine was a meniscus tear with a little bit of just cleaning up the cartilage. It helped for a year or so, but not as much as I hoped. I also had alignment problems. My kneecaps didn't sit in the right place, so the groove was mostly ok, but the back of the kneecap had almost no cartilage left.
When my sister was 13, she dislocated her kneecap (only temporarily, unlike mine that never were in the right spot). After that she would occasionally have times when she just about couldn't walk. Described it as feeling like something was floating around in there and would occasionally get stuck in the wrong place. She had debridement arthroscopic surgery when she was about 38. The doctor removed 1 good sized piece of cartilage, not sure where it came from. No problems since. She's now 41.

 

[NorthumbriaKnee]

And if you’d like a new title for this thread just let us know what you want and we’ll change it for you.

Hi Jockette,

Could this thread possibly be renamed to 'patella cartilage debridement' please ?

 

[Jockette]

Title changed!

 

[ColoradoSnowman]

Hi there,

I am new here but I'm intrigued by ColoradoSnowman's story.

I'm happy to share my experience. First of all post debridement it was on a scale of 4-8 weeks before I felt pretty good with use. Second my pain/disfunction really bit when I would bend a knee under load, maybe starting at 15 degrees. I assume that is when the patella would hit on the bear spot in my trochlear groove. Both docs I worked with were optimistic that a debridement and PT would be enough, but in the end it just kept on getting hurt, even swimming freestyle hurt as the flutter kick had just enough knee bend to hit the sore point.

My path, if you've read my recovery thread brought me to an OATS procedure (actually more properly an OCA). Early days, but so far it seems to be healing nicely and the doc says if it works it should last me a life time. Happy to chat if you want to DM.