Saturday, December 5, 2015

More Evidence That Cartilage Can Heal

As you all know, nothing cheers me like a good success story – or even a small yet significant victory on the long road to healing.

Well, one member of our small community here who uses the handle gcoza posted this comment this week:
Today I went on my second MRI of my left knee. The first was prior 27 months and showed significant chondromalatia patella on the upper medial side of the patella in the area of 12x9 mm. New MRI medical report showed no sign of chondromalacia patella. Nothing!!!
He even posted the before and after images of his knees here.

This is great news, but if the irregular cartilage has really filled in, I’m not that surprised. As I mention in my book, clinical studies show that cartilage defects can change A LOT over two years. Places where the cartilage is worn almost to the bone can suddenly look almost as good as new.

I can remember reading all this and thinking, “Damn, this is big. I’m reading all these articles and books about healing bad knees. Why doesn’t anyone mention this?” Instead, much of the prevailing thinking cleaved to a sort of “car part” model, if you will. That is, you could think of your knee cartilage like the tread on your brand-new tires. After time, it simply wears down.

It’s a simple, fatalistic, and profoundly flawed way to analogize about human bodies, which are full of cells that are constantly renewing. Hell, if we weren’t built that way, all of us would die of senescence at the age of three or so.

So congrats to gcoza. He is quick to note that he hasn’t beaten knee pain yet. He’s better, but still has a good way to go. But man, it must feel unbelievably good to stare at an MRI that essentially says, “Hey, all your hard work at recovery is paying off.”

Now, granted, that fill-in cartilage is probably of the inferior fibrocartilage variety that’s less durable than the original. But as I have mentioned before, over time fibrocartilage has been shown to begin to take on characteristics of normal hyaline articular cartilage.

Update: I feel that I should share this. Gcoza has now said that the MRI was faulty and that the cartilage didn't completely heal. Here are some excerpts from his latest comment:
Unfortunately, I went for another MRI because my orthopedist said that the pictures are not of sufficient quality. This time images are much better quality and revealed chondromalacia patella 1b.- 2 grade on both knees. Im feeling about the same. Neither better nor worse. Status quo. My next step would be stem cells treatment because I tried more-less every other possible option ... Conclusion is: chondromalacia is irreversible, but with time one can feel better. Now, three years from the beginning of my knee problems , constant pain was reduced by at least 50-70%, and the function of the knee is also improved by at least 50%. Now I can squat. Three years ago I could not walk up and down stairs.
Okay, so this isn't the success story I was hoping for. However, he has reduced his pain and improved the function of his knee. That's some progress. Getting better can take a long time unfortunately. Maybe he'll have success with stem cell treatments. If he does, I'll report back.

15 comments:

  1. Richard, you are so good with words.
    And yes, the feeling was so good that I started to cry.

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    1. gcoza, I would be very interested to hear what your physical activity/rehabilitation program involved between the first MRI scan and the second one. What would you say have been the keys to success thus far, for you personally? Did you notice much of a change in your symptoms over the 27 month time frame? Amy S.

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  2. OMG this is so awesome!! Congrats gcoza! Happy for you! Why the heck doctors keep telling people their favourite thing:"wear and tear" has no solution? There are studies and real cases showing that cartilage can heal. Why practitioners don't read them? Seriously, if I would be an orthopedic doctor I would have some interest in reading the latest studies/findings in my field! I don't understand what's going on...

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    1. Many of them are just covering their butts by trotting out the worst case scenario. I also think the speed at which they push patients through these days has something to do with it. They are just not interested in listening for too long, so fob you off with "it's just the aging process, things wear out".

      Interestingly, my GP who was a runner and had been through patella chrondro himself indicated to me you could get improvement (he had), but that the process was like climbing a slightly upward tilted sawblade (i.e. lots of ups and downs but gradually heading in the right direction) which has proven to be very accurate in my case. Even then, I doubt he thought I'd still be climbing the blade after 4 years, and some of the leg strengthening exercises he recommended were too much. But at least he gave me some hope!

      My OS offered no real clues on where I might end up or what to do, other than that he did not think more surgery was the way to go - which was good advice.

      I learned most clues from blogs like this and people on the same journey.

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  3. As per previous post and current question: US population = 330,000,000. Divide by 100,000 = 3300. Multiply by 231 = 762,300 (TKR). Multiply by $53,000 (avg. cost of TKR in US, UK is 11,700 USD, oversight included) = $40,401,900,000.
    That's a lot of reasons.

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  4. It's very uplifting! I suspect most people would be put off by the thought of the time it takes. Also the fact that yoy can get many setbacks. I followed the slow road and I don't regret it. My knees are much better now, witg some ups and downs still, but I'm getting there!

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  5. Richard, I have some desperate questions in regards to your recovery and journey in regenerating cartilage. I cannot find your contact details, please email me: juls_footy@hotmail.com

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    1. Hi J,
      Actually, I've stopped giving out my e-mail address because, honestly, I started getting a lot of requests from people who wanted to chat about their knees. Believe me, I understand the frustration and desperation! But the best thing to do is to drop your questions in the comments section here. I check this each week and there are other commenters here who have bad knees who may have better insight than me into your particular problem. A great community has built up around this blog, to my pleasant surprise. Cheers!

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    2. okay that's fair enough, I'm 16 years old and 6-8 months ago i tore the cartilage in my right knee cap, for the first 3-4 months(before i got an MRI) i was told it was a strain and to strengthen my quads so i pushed through the pain to try and build strength but it continuously got worse, after i got a scan done it was found there was a tear in the cartilage however it was a flap, so still connected partially on one side. I've been told there's nothing i can do and to wait 6-12+ months to see if it will regrow however i have had to drop all sport and physical activity. I'm quite frustrated and want to know if anything can be done, taken or procedure followed to ensure the cartilage can grow back and grow back quicker. Currently it hurts whenever i squat or stand up on the leg. Thanks

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    3. Well, the good news is you're 16. The bad news is, if you want to avoid a lot of heartache as an adult, you may need to make some radical changes now. Don't know what sports you do, but I'd think about forgetting them all for a while and taking up a sport like cycling. I'd do it easily at first, then build up intensity. HOWEVER -- I don't really know anything about your case, or about how bad your injury is, or what would make it worse, so if I were you, I'd go to my doctor and ask him what he thinks about cycling, first gently. You can even cycle backwards on a stationary bike for no resistance.

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  6. Why isn't meniscus transplant an option? I was hit by a car walking. ... everyone as I'm a senior. .. blames on age. I can't stand the right of not being a hiker for life.

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  7. Meniscus transplant is possible. Look up collagen meniscus implant.

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  8. I require help. I have bilateral chondromalacia patella suffering since two years. I have quit my job 5 months back to recover from this bilateral knee pain. Iam inspired by 'saving my knees' book which has been my only hope. Can you please tell me an effective way to stretch the quadriceps muscle as Iam unable to stretch it as I cannot bend my knee beyond 95 degree without pain in my knee joint as being done in the conventional method. Kindly help.

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  9. Richard, any update on below? I've been interested in the same stem cell therapy.

    -> Maybe he'll have success with stem cell treatments. If he does, I'll report back.

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  10. Don't recall anything, but Gcoza is a frequent visitor. Gcoza, are you out there reading this? Anything to report?

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