Drum roll please......The Results!

Today I got my MRI results and you, dear readers, get the low-down first.

First, a history...In 1996 I suffered a meniscus tear (cartilage in the knee between the femur and tibia) from a knee trauma during a soccer game. I couldn't even walk. Had a knee scope to remove the torn portion of the cartilege. Tears deep in the meniscus will not heal even if surgically repaired since blood flow is scarce to that area. It turns out removing the torn pieces will relieve the pain and prevent the tear from 'catching' in the joint but it is degenerative. The cartilage cannot 're-grow' and eventually in life you will wear away the cartilege on the end of the bone and likely suffer from osteoarthritis. In 2000, I suffered further tearing that left me unable to walk stairs and with daily significant pain so I had a second knee scope. Since then I get minor aches and pains and minor swelling, but no major pain.

Until three weeks ago. I have had pain while running that I am unable to work through. So I had an MRI last week. Eight years is pretty good to go without any big issues I think. But since I know there is no 'fix' for me, I was very sad to see this come up.

The results are...

1) Abnormal appearance of the anterior and posterior horn of the lateral meniscus with diminuitive appearance and irregular shape.

Here is where I am missing cartilage (on the outside of my knee). This can likely be the result of my previous surgeries where is was removed. However, a recurrent meniscal tear here could not be excluded.

2) Very small foreign body between patella and femur

This is the likely culprit for my knee locking but is small enough that it isn't a real need to remove it.

3) Thinning of articular cartilage along lateral compartment with adjacent abnormal subchondral marrow

I lack cushioning here. Subchondral bone marrow lesions are involved in pain and progression of knee osteoarthritis.

4) Chrondromalacia involving the medial and lateral patellar facets

aka - Softening of cartilege of your knee cap or 'anterior knee pain.' The surface of the patella is softened due to many things including abnormal pressure across the joint surface. Causes swelling and pain when the knee is bent for long periods of time, kneeling or stair climbing. Commonly thought to be hereditary!

Diagnosis: Bad knee with wear and tear. There is nothing definitive on the MRI that says I need surgery. It could be a recurrent tear but the only way to know if it's just shaved from previous surgery or from a tear is surgery. (I honestly think there may be a small tear from the kind of pain I've had, but since biking, swimming, and elliptical have caused no pain I'm hopeful it was small or just irritated). We could go in and try and clean it up but there is always the chance that I come out worse than before. There is only so much shaving you can do.

So knowing there is no physical deformity that is going to explode if I run (and that my ligaments all look good), I'm going for physical therapy and will attempt short treadmill/track/dirt running. I'll go back to the ortho in a month and see how things are going. If I can manage running without pain there is no reason why I can't continue. And if things don't get better I can opt for surgery later.

Basically this is about choice. I can choose to give up activities I like doing and not pursue therapy or surgery. Or I can choose to do everything possible to keep up my pursuits at this point. So I've made my choice to keep going and try what I can to continue. This isn't like a bone deformity - it won't cause me long-term damage because the damage is already there. Either way my long-term prognosis is that at some point in life I will likely give up running for good. Eventually the pain may catch up and I will have to stop. But I'd like to delay that a little. Maybe 20 years. ;) In the meantime, we'll see what therapy and a little weight loss can do for me.

So wish me luck in therapy!