The Surgery
On Monday, December 7 I underwent surgery to repair three problems with my right knee.
The primary lesion (the one that began to impact my running
in late 2018) was a full-thickness, 1-cm, chondral defect on the lateral femoral trochlea.
(Full description from MRI report: There is impending delamination of cartilage
with full-thickness cartilage fissuring as well as linear basilar hyperintensity
at the lateral trochlea where there is adjacent intraosseous ganglion cyst
formation as well as a severe surrounding stress reaction in the bone.) The injury was repaired with a single osteochondral allograft (donor bone/cartilage).
A second issue was a 1.5 x 2.0 cm Stage 3 cartilage defect on the medial
condyle (not clear this was causing significant symptoms...see below). This was repaired using 3 osteochondral autografts (my own bone/cartilage from a non-weightbearing donor site (the lateral femoral notch)).
The third injury treated was a small horizontal degenerative
tear of the medial meniscus, which is a second candidate to have caused sudden-onset medial
knee pain I experienced in late 2019…that eventually led me to stop running
completely. Approximately 20% of the medial meniscus was removed.
Things seem to go smoothly on the day of the surgery. I arrived in NYC at 5:30 AM for the 7:00 AM procedure. The anesthesia was a combination of sedation with a spinal and regional nerve blocks. Before 9 AM I had awakened to find myself in recovery. I was told the surgery had gone well. By about 9:30 or so I was ready for pickup by my family for the trip back to beautiful New Jersey.
I finally requested and received the notes from this surgery. Some more details...
ReplyDeleteThere was a complex tear of the medial meniscus. About 20% of the meniscus was removed. The lateral trochlear cartilage lesion was grade 4 (full thickness) and about 1 cm in diameter. It was filled with an allograft (donor bone/cartilage). The medial femoral condyle cartilage lesion was grade 3 (not quite full thickness) and was about 1.5 x 2.0 cm. It was filled by 3 autograft plugs harvested from the lateral femoral notch.
I was surprised to find that an allograft was used for the trochlear lesion. I was also surprised that the medial condyle cartilage lesion was larger than the trochlear lesion (though it was not quite full thickness to the bone). I was pleased to find out that only 20% of the medial meniscus was removed. Keeping more meniscus reduces the likelihood of arthritis.