It's a cartilage and plastic thing. Structurally, all is well.
Approximately 25% of the posterior (back. 'reflected' in picture above) of my patella is plastic. The rest of the patella and knee joint are normal cartilage and ligaments. With every step and bend of my knee, the patella tracks (rides) in and along the front of the knee joint/knuckle (Patellofemoral groove) which are normal cartilage. The plastic portion of my patella is slightly harder than cartilage. That difference in hardness between the two surfaces will, over time, result in some wear on the joint groove and thus loss of cartilage on the joint.
This plastic was the fall-back option of my surgery. The first option was to remove the rotten cartilage and bone from the patella and then take some cores of natural bone and cartilage from a spot on the femor (Distal femoral condyle) and plug those cores into the void on the patella. Known as 'Oats procedure'.
However, the void on my patella was too big to accept the Oats procedure so we put a piece of nickle-sized plastic in the void. This should last me 20 years if I don't run on it.
If I were to run and continue with iron distance triathlons, or any long distance running, that simply puts extra wear/miles on the Patellofemoral groove and thus a shorter life on the cartilage do to the plastic wearing on it.
The orthopedist didn't say I can't run anymore at all but that would be best if I didn't run. He did say I could run very short distances on flat surfaces. Any downhill running puts even more pressure on the patella against the Patellofemoral groove and thus, additional wear on the joint. He said if I choose to run more, the life of my current knee would be less than 10 years.
So I have a choice here. Keep doing iron distance training and tris for the next few years or lay off the running and do all kinds of other sports for the next 20 years or so.
What happens after 20 years? Most likely another surgery to replace worn out cartilage or a full joint replacement. We'll see.
For now, I'm staying active with no-knee-impact sports I just got an invite to help out at an outrigger canoe race in Santa Barbara next week.
Maybe I'll enter and get my ass handed to me. Paddling could be fun.
7 comments:
very intereting post! thanks for writing it all down, gives me some insight into the workings of the knee and my own knee pitfalls.
you should go to SB, i love it there :)
Thanks for answering! There may be other options for us in the next 10 years than joint replacement. But the name of the game seems to be keep the joint healthy, so you have more options later. I wrote the "Tri Doc" at Triathlete Magazine with a bunch of questions regarding knee cartilage. He promised to respond! Will keep you posted. Have fun out there!! What a change of scene for ya'! Bring warm clothing. Santa Barbara's water is frigid, even in August!!!
dude, you are so positive and optimistic in your blog about this thing. I think I would be floored and/or devastated.
what about uphill-only running? We have this race here you might be interested in, if uphill is OK.
and yeah - there's always AquaBike - more and more iron distances are including Aqua bike in the mix.
Your outlook is inspiring.
Wow. That's a tough transition you're going through. Sounds like you're being very optimistic about it though.
thanks for the update....you are way more sane than many out there who may just keep training through it and ruin their body. pretty impressive also that you are looking at more of what you CAN do than what you can't do.
awesome.
you have such a great attitude! I have a kayak and yes, it is a good hard workout, have fun..:-))
Eeeshhh Benson! I've been so MIA, I'm just now catching up with your knee saga! Bless your heart!!! First, cannot believe you watched the surgery go down! Wow! And even more wows for how quickly you seem to be recovering... cross-counrty skiing and now, canoeing?! There's something to be said for the whole "when one door closes" adage...
I'd forgotten (aside from the knee woes of course) how lovely your life is... as always love the pics of the wildlife, your dog, snow, and the amazing place you live. take a deep breath of chilly, fresh air for me today! Be well & here's to you and new adventures!
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