HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Hello, Got The Following MRI Report - There Is A

default
Posted on Wed, 10 Jul 2019
Question: Hello,
Got the following MRI report -
There is a full-thickness defect in the articular cartilage of the posterior medial femoral condyle, measured 8 mm in transverse and 5 mm in craniocaudal dimensions consistent with grade 4 cartilage injury

Summary
1.  Mild mucinous grade 1 signal loss in the medial meniscus.
2.  Mild bone marrow edema or bone contusion in the posterior medial femoral condyle. No definite fracture line seen.
3. There is grade 1 signal loss of posterior superior part of the anterior cruciate ligament.
4. Grade 4 cartilage injury involving the posterior medial femoral condyle.
5. Moderate joint effusion.
6. There is likely a small lymphnode in the popliteal fossa and is not significant.

Medial pain in knee - clicking, Gave had this acute pain for 3 weeks / taking anti inflammatory- not much help.
Extremely active 49 year old who would like to return to high level competition in tennis as soon as possible. The grade 4 defect is what worries me - am I heading to surgery? What kind of surgery. Any other treatments available?
Thank you,
default
Follow up: Dr. Dr. Praveen Tayal (0 minute later)
Hello,
Got the following MRI report -
There is a full-thickness defect in the articular cartilage of the posterior medial femoral condyle, measured 8 mm in transverse and 5 mm in craniocaudal dimensions consistent with grade 4 cartilage injury

Summary
1.  Mild mucinous grade 1 signal loss in the medial meniscus.
2.  Mild bone marrow edema or bone contusion in the posterior medial femoral condyle. No definite fracture line seen.
3. There is grade 1 signal loss of posterior superior part of the anterior cruciate ligament.
4. Grade 4 cartilage injury involving the posterior medial femoral condyle.
5. Moderate joint effusion.
6. There is likely a small lymphnode in the popliteal fossa and is not significant.

Medial pain in knee - clicking, Gave had this acute pain for 3 weeks / taking anti inflammatory- not much help.
Extremely active 49 year old who would like to return to high level competition in tennis as soon as possible. The grade 4 defect is what worries me - am I heading to surgery? What kind of surgery. Any other treatments available?
Thank you,
doctor
Answered by Dr. Dr. Praveen Tayal (7 hours later)
Brief Answer:
Surgical repair needed.

Detailed Answer:
Hello,
Thanks for posting your query.

You seem to have a full thickness tear of the articular cartilage. This needs surgical repair for best healing. You can go for an arthroscopic repair of the cartilage which will help in earlier recovery. You can discuss with your Orthopedician regarding the options.

Another treatment is a conservative treatment but a full thickness tear is not likely to heal conservatively. so, it is best to go for surgical repair.

I hope this answers your query.

In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Wishing you good health.

Regards.
Dr. Praveen Tayal
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Dr. Praveen Tayal (0 minute later)
Brief Answer:
Surgical repair needed.

Detailed Answer:
Hello,
Thanks for posting your query.

You seem to have a full thickness tear of the articular cartilage. This needs surgical repair for best healing. You can go for an arthroscopic repair of the cartilage which will help in earlier recovery. You can discuss with your Orthopedician regarding the options.

Another treatment is a conservative treatment but a full thickness tear is not likely to heal conservatively. so, it is best to go for surgical repair.

I hope this answers your query.

In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Wishing you good health.

Regards.
Dr. Praveen Tayal
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
default
Follow up: Dr. Dr. Praveen Tayal (2 hours later)
Hi Dr. Tayai,
Thank you for your answer.
Could you please tell me:
What kind of surgery is needed based on the size of the defect (name of it - ie chondroplasty, graft transfer, partial knee replacement or something else?)
Also - would be appreciate an approximate recovery time based on different surgery options as well if it is possible to come back to high level sports - in my case tennis where it is a lot of twisting motion.
Thank you for your help.
Mattias
default
Follow up: Dr. Dr. Praveen Tayal (0 minute later)
Hi Dr. Tayai,
Thank you for your answer.
Could you please tell me:
What kind of surgery is needed based on the size of the defect (name of it - ie chondroplasty, graft transfer, partial knee replacement or something else?)
Also - would be appreciate an approximate recovery time based on different surgery options as well if it is possible to come back to high level sports - in my case tennis where it is a lot of twisting motion.
Thank you for your help.
Mattias
doctor
Answered by Dr. Dr. Praveen Tayal (13 hours later)
Brief Answer:
Condroplasty will help in healing.

Detailed Answer:
Hello.
Thanks for writing again.
Usually chondroplasty is sufficient to heal such kind of injuries. Partial knee replacement is considered in patients above 60 years of age.
After chondroplasty you can return to normal activities in 4-6 weeks and return to high level sports in 12 weeks after regular physiotherapy.
In case of partial knee replacement return to high level sports is not likely.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dr. Praveen Tayal (0 minute later)
Brief Answer:
Condroplasty will help in healing.

Detailed Answer:
Hello.
Thanks for writing again.
Usually chondroplasty is sufficient to heal such kind of injuries. Partial knee replacement is considered in patients above 60 years of age.
After chondroplasty you can return to normal activities in 4-6 weeks and return to high level sports in 12 weeks after regular physiotherapy.
In case of partial knee replacement return to high level sports is not likely.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Dr. Praveen Tayal (13 hours later)
Thank you again Dr.
is this surgery needed right away or is it possible to be pain free with injections and compete this season and have surgery at the end of the season in 6 months - or do you think that injections will not help in my case!

Also - can it be further damage to continue playing if I can manage the pain or will it gradually be worse wether or not I play or rest?

Thank you very much!
Mattias
default
Follow up: Dr. Dr. Praveen Tayal (0 minute later)
Thank you again Dr.
is this surgery needed right away or is it possible to be pain free with injections and compete this season and have surgery at the end of the season in 6 months - or do you think that injections will not help in my case!

Also - can it be further damage to continue playing if I can manage the pain or will it gradually be worse wether or not I play or rest?

Thank you very much!
Mattias
doctor
Answered by Dr. Dr. Praveen Tayal (20 hours later)
Brief Answer:
It is better to go for surgery.

Detailed Answer:
It is best to go for the surgery as soon as possible. Playing sports with this injury can further damage the torn cartilage. Taking pain killers can only reduce the pain and other symptoms but will not help much in healing.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dr. Praveen Tayal (0 minute later)
Brief Answer:
It is better to go for surgery.

Detailed Answer:
It is best to go for the surgery as soon as possible. Playing sports with this injury can further damage the torn cartilage. Taking pain killers can only reduce the pain and other symptoms but will not help much in healing.
Regards.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12314 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Hello, Got The Following MRI Report - There Is A

Hello, Got the following MRI report - There is a full-thickness defect in the articular cartilage of the posterior medial femoral condyle, measured 8 mm in transverse and 5 mm in craniocaudal dimensions consistent with grade 4 cartilage injury Summary 1.  Mild mucinous grade 1 signal loss in the medial meniscus. 2.  Mild bone marrow edema or bone contusion in the posterior medial femoral condyle. No definite fracture line seen. 3. There is grade 1 signal loss of posterior superior part of the anterior cruciate ligament. 4. Grade 4 cartilage injury involving the posterior medial femoral condyle. 5. Moderate joint effusion. 6. There is likely a small lymphnode in the popliteal fossa and is not significant. Medial pain in knee - clicking, Gave had this acute pain for 3 weeks / taking anti inflammatory- not much help. Extremely active 49 year old who would like to return to high level competition in tennis as soon as possible. The grade 4 defect is what worries me - am I heading to surgery? What kind of surgery. Any other treatments available? Thank you,