I am F, 31 diagnosed with grade 2 chondromalacia patellae, how many "grades" are there possible to be had?

Question:

I had an M.R.I. on my LEFT knee and the radiologist stated: Full thickness fissuring of the articular cartilage of the median ridge of the patella. The remainder of the patellar cartilage demonstrates globular intrasubstance increased signal. There is no osteochondral defect or fracture line. Bone marrow signal is unremarkable.. I also have a trace popliteal cyst.

I have had a bit a knee "experience" before. two surgeries on my RIGHT knee, one in late 1996 and another in late 1997 to fix the stuff they "missed" in 1996. Meniscus tears.back to the present.

My doctor didn't really say whether this was good news or bad news. He just gave me the # to the ortho. surgeon. and sent me on my way?
I wasn't able to walk for two days and I am using crutches.
We thought it was an ACL tear. So this is NOT what I expected to hear. Can anyone translate a bit or tell me the ballpark chances that I might have to have my kneecap replaced or how long and hard will recovery be after a "cleanout"?

Answers:
There are 4 grades.

I swelling of the superficial layer of hyaline cartilage with breakdown of the network of collagen fibers
II fibrillated cartilage with surface breaks that extend to the middle layer of the hyaline cartilage
III breaks in the hyaline cartilage extend to the deepest layer, almost to the depth of the subchondral bone
IV destruction of the hyaline cartilage with exposure of subchondral bone, indistinguishable from degenerative joint disease (osteoarthritis)

I believe that in stage 2 it is very possible that you will not need surgery, but can go to therapy. Sometimes the build-up of damaged cartilage is too great and they will have to shave down the scarred tissue, drill to allow healthy tissue to grow through the holes, or realign to prevent further damage.

Usually, a patelectomy, partial or total (that is a knee replacement) is rare unless there is very severe damage.

Don't just let them cut you open without more than one opinion. Sometimes, orthopedic surgeons like to solve everything the surgery way. This doesn't mean that they don't have your best interests at heart, they just want to solve it that way, when there may be more than one way to fix it.

It seemed like your biggest concern and problem is Chondromalacia, if you want me to explain the other stuff, let me know. It's kind of sad how doctors can't spend the time telling their patients what is wrong in normal terms.

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I am F, 31 diagnosed with grade 2 chondromalacia patellae, how many "grades" are there possible to be had?

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